Latex allergies and plastic surgery

Allergic reactions to latex are becoming more common. Today, about 3 to 6% of people are found to be allergic to latex...and in the worst case, the reactions can get pretty serious. Prevention, rather than treatment after the fact, is really the key to success.

Latex is the milky fluid from the rubber tree, Hevea brasiliensis, found in Malaysia, Indonesia, Thailand, and South America. In addition to the organic polymer that gives it the characteristic stretchy properties, latex sap also contains more than 200 allergenic proteins.

In terms of surgical history, William Halstead was the first to use latex surgical gloves, back in 1890. Recently, as we've become increasingly aware of the need for protection against blood-borne pathogens, the use of latex gloves has skyrocketed. Simultaneously, the incidence of allergic reactions to latex began to rise in both patients and especially in health care workers.

Latex exposure is associated with 3 distinct clinical syndromes.

1) irritant dermatitis. This is the most common cause of latex-induced skin rashes. It is not associated with allergic complications.

2) contact dermatitis. Symptoms usually develop in a delayed fashion, within 24-48 hours of cutaneous or mucous membrane exposure to latex in a sensitized person.

3) immediate hypersensitivity. This is the least common, but most serious type, and is a classic allergic reaction against latex proteins. Symptoms generally begin within minutes of exposure. Symptoms range from rash and itching, runny nose and watery eyes all the way to bronchospasm, hypotension and full blown anaphylaxis.

Interestingly, certain other tropical fruits can have an allergic cross-reactivity with latex allergy: avocado, banana, chestnut, kiwi, papaya, peach, or nectarine. People who are allergic to one are more likely to allergic to the other.

So, what do we do if someone says they have a latex allergy? First, as best as possible, we try to learn the story, and get the details of what happened. What kind of reaction did they have? Was it immediate or delayed? If there are further unanswered questions, evaluation by an Allergy specialist is helpful.

Fortunately, with the increased awareness of this problem, most operating rooms (including our own) have the ability to use a latex-free set-up. There is no latex whatsoever in the anesthesia equipment set-up, the rubber syringes, IV tubing, the surgical gloves and gowns, surgical tapes and dressings. By avoiding any exposure to even the smallest bit of latex, the patients can do very well, and have a safe operation. Also, breast implants do not contain any latex - so they don't have the potential for a latex reaction.

If you think you might be allergic to latex, please mention it to your surgeon. With proper preparation, latex allergy issues can be avoided.