So you’re considering the Nuss procedure and have heard about the risk of metal allergy. Should you get allergy testing? Firstly, ask your surgeon, as some surgeons will require it. Others may give you the option.
If you have a personal or family history of metal allergy, yes. If you are a female, consider it seriously. Otherwise, it’s really up to you.
All in all, the American Contact Dermatitis Society recommends testing for all patients undergoing Nuss repair.
In perhaps the largest study conducted on the matter, 15 (1.8%) of 842 stainless steel (traditional material used) Nuss repairs resulted in a bar allergy. Of the 15 patients with bar allergies, 5 (33.3%) had a negative allergy testing result before surgery. This means that you can still have a postoperative metal allergy even if you test negative for the allergy before your surgery.
Another fascinating result that came out of this study was that a positive patch test (allergy testing) was more common in females (about twice as common) and substantially more in people with a personal or family history of metal allergy.
It is important to note that in cases when allergies are a concern, titanium bars may be implanted. However, note that titanium is also not a completely inert metal and allergies to titanium have also been reported. Titanium bars are also less rigid and can lead to more discomfort after surgery. Also, titanium bars are much more expensive!
Let me know if you have questions.