Question

Please explain the significance of a known shellfish allergy prior to performing a surgical skin scrub, and which prepping solution in particular is related to this concern. Do you think it is important to know all patient allergies even if you dont think they are relative to or will affect the elements of surgery? Why or why not?

Answer 1

Shellfish allergy

Shellfish allergy is one of the common food allergy, in which the person will be hypersensitive to food items or products  that prepared out of shellfish and its products. Shellfish refers to an aquatic invertebrate, such as molluscs ( mussels, oyster) or crustaceans ( crab, lobster), that has a shell.

It is important to know regarding patient's allergic responses especially on shellfish, prior to surgical skin scrub, as shellfish allergy patients may develop allergic reactions to certain prep solution that used for skin scrubbing.

Solutions that contains Iodine ( Povidone iodine- Betadine) should be avoided as skin scrub in patients who have shellfish allergy. It is not because of Iodine, as Iodine itself is not an allergen. but some components that mix with the solution might cause allergy in hypersensitive patients. ( shellfish allergy is due to Parvalbumins and tropomyosins that found in shellfish). Studies show that Iodine is not an allergen.

It is important to know all patient allergies, even if it is related or not related to the elements of surgery. Hypersensitive individuals are in danger as they may develop asthma, atopy or Anaphylaxis at times, when they come across with an allergen. It might be a medicine or a cleaning solution or even to anaesthetic drug the person's body may respond abnormally due to allergic condition. So it is important to know the complete history of patient on  allergies/ allergological assessment as the information may help the health team to prepare in advance the precautionary measures against allergies or allergic reactions such as swelling, redness, hives, asthma, atopy, hypotension etc.