Patients with eczema, asthma, or other allergic conditions had higher postoperative risks—including infection, implant complications, and the need for revision surgery—compared with patients without atopic disease, according to recent studies presented at the 2025 Annual Scientific Meeting of the American College of Allergy, Asthma & Immunology.
Patients with allergic conditions, including eczema, asthma, and allergic rhinitis, experienced significantly higher rates of postoperative complications in two large retrospective cohort studies. The researchers reported that atopic disease is characterized by immune dysregulation, which can impair healing, increase susceptibility to infection.
In the first study, researchers analyzed data from more than 20,000 women who underwent implant-based breast reconstruction after breast cancer surgery between 2002 and 2022. After 1:1 propensity score matching for demographics, comorbidities, treatment exposures, and autoimmune disease, each cohort included 10,205 patients with or without atopic skin disease. Women with eczema, dermatitis, or other allergic skin conditions had greater risks of implant-related complications at 1, 2, and 3 years postoperatively, capsular contracture at 2 and 3 years, and revision surgery at all time points. Implant removal was also more frequent (at 1-3 years), as were implant infections (at all time points) and implant rupture at 2 and 3 years.
In the second multicenter analysis of more than 38,000 adults who underwent bone graft procedures, investigators used the TriNetX network to compare 19,334 with atopic disease and 19,334 matched controls. At 90 days, the atopic cohort had increased risks of infection or wound complications, osteomyelitis, and hardware removal. At 2 years, the elevated risks persisted for infection or wound complications, osteomyelitis, mechanical loosening, and revision surgery. No differences were observed in graft failure, pathologic fracture, surgical debridement, or opioid use.
Researchers reported no conflicts of interest.
Source: 2025 Annual Scientific Meeting of the American College of Allergy, Asthma and Immunology
