Reakcije preosjetljivosti na medicinske uređaje

master's thesis

• Title (english): Hypersensitivity reactions to medical devices
• Author: Luka Kamenečki
• Mentor: Suzana Ljubojević Hadžavdić (mentor)
• Committee member: Zrinka Bukvić Mokos (predsjednik povjerenstva)
• Committee member: Romana Čeović (član povjerenstva)
• Committee member: Suzana Ljubojević Hadžavdić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Dermatology); Zagreb
• Defense date and country: 2023-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Dermatovenerology

Abstract

Pojam medicinski uređaji pokriva širok spektar stvari i aparata koji dolaze u kontakt s tijelom pacijenta i medicinskog osoblja. Materijali od kojih su izrađeni uređaji izazivaju kontaktne reakcije u predisponiranih osoba. Reakcija je imunološki posredovana te odgovara tipu IV reakcije po Coombsu i Gellu. Najčešći alergeni su ioni metala (nikal, kobalt, krom), plastični materijali (akrilati i epoksidne smole) i prirodni lateks. Reakcija se pojavljuje u akutnom i kroničnom obliku. Znakovi akutne reakcije su pruritus, crvenilo i vezikule. Znakovi kronične reakcije su zadebljanje kože i lihenifikacije na mjestu kontakta kože s uređajima. Najčešće mjesto reakcije su ruke koje čine pola svih incidencija. U slučaju prisutnosti ovih znakova i osnovane kliničke sumnje preporučeno je napraviti epikutani (patch) test. Epikutani test je zlatni standard u dijagnostici kontaktne reakcije. Test se provodi na leđima pacijenta te se koriste standardizirane serije alergena. U slučaju pozitivne reakcije, prva linija liječenja je izbjegavanje kontakta s izvorom alergena. Za uređaje koji su implantirani unutar tijela pacijenta to znači dodatne operacije i stres za organizam. Ovisno o težini kliničke slike, potrebna je lokalna ili sistemska terapija kortikosteroidima. Dodatno je preporučena terapija ublažavanja simptoma pomoću neutralnih krema ili losiona te, ako je moguće, uvođenje barijere između izvora alergena i tijela pacijenta.

Abstract (english)

The term medical device covers a wide spectrum of things and devices that come into contact with the bodies of patients and medical personnel. Materials from which the devices are made out of cause contact reactions in predisposed people. The reaction is immunologically mediated and corresponds to the type IV reaction by Coombs and Gell. The most common allergens are metal ions (nickel, cobalt, chromium), plastic materials (acrylates and epoxy resins) and natural latex. The reaction comes in an acute and chronic form. The signs of an acute reaction are pruritus, redness and vesicles. The signs of a chronic reaction are skin thickening and lichenification on the site of the skins contact with the device. The most common site of the reaction are hands which make up half of all incidences. In the case of presence of these signs and a founded clinical doubt an epicutaneous (patch) test is recommended. The epicutaneous test is the golden standard in diagnosing contact reactions. The test is conducted on the backs of patients and a standardized series of allergens are used. In the case of a positive reaction, the first course of treatment is avoiding contact with the source of allergen. For devices which are implanted within the body of the patient it means additional surgeries and stress for the organism. Depending on the severity of the clinical picture, a local or systematic therapy of corticosteroids is needed. Additional therapy of symptom mitigation by means of neutral creams or lotions and, if possible, introducing a barrier between the source of allergens and the body of the patient is recommended.

• Keywords: medicinski uređaji; kontaktna reakcija; epikutani test
• Keywords (english): medical devices; contact reaction; epicutaneous test
• Language: croatian
• URN:NBN: urn:nbn:hr:105:955027
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-10-25 09:47:00