CONCLUSION
ACD to suture material should be considered in patients who present with
early and delayed post-procedural induration and erythema, particularly
in the setting of repeated culture-negative episodes. This report
highlights the potential for triclosan, and specifically
triclosan-coated sutures, to contribute to ACD. A single interrupted
stitch test into the dermis improves the sensitivity of in vivo testing
for suture hypersensitivity when conventional patch allergen testing
proves negative. While this recognized entity remains an infrequent
procedural complication, this is a treatable phenomenon which results in
significant patient morbidity and increased costs to the healthcare
system. Early consideration of ACD and engagement by a
multi-disciplinary team including Infectious Disease and Allergy &
Immunology leads to efficient diagnosis and improved patient outcomes.