Utility of routine patch testing prior to surgical repair of pectus excavatum: A multidisciplinary experience via retrospective review at a single tertiary care center.

BACKGROUND The Nuss procedure is the only implant procedure in which routine, rather than selective, preoperative patch testing is recommended. This practice has recently been called into question. OBJECTIVE To evaluate an updated experience of pre-implant patch testing in patients undergoing the Nuss procedure. METHODS A retrospective chart review of Nuss procedures from 2012 through 2020. RESULTS Forty-five patients were identified for data collection. From 2012 to 2014, none of the 14 patients were patch tested. From 2015 to 2020, 26 of 31 (83.9%) were patch tested. Of those tested, only 2 had a positive patch test. A hypoallergenic titanium bar was inserted in each case. In total, there were zero bar reactions. CONCLUSION The risks of patch testing are extremely small and should be weighed against the serious implications of even one bar allergy when deciding on future guidelines.