Atopic Diseases Significantly Raise the Risk of Post-Surgical Complications

Two new studies presented at the 2025 American College of Allergy, Asthma, & Immunology (ACAAI) Annual Scientific Meeting in Orlando, Florida, suggest that allergic conditions like eczema, asthma, and hay fever may heighten the risk of post-surgical issues.1 These findings indicate that these conditions’ inflammatory and immune effects may impede healing and increase postoperative infection risk.

“People with eczema or similar skin conditions already have more sensitive skin and a higher level of inflammation,” said Philong Nguyen, BS, a medical student at the University of Texas Medical Branch (UTMB) John Sealy School of Medicine, in a statement.1 “That seems to make surgical healing more difficult and increases the chance of infection.”

Atopic Diseases Raise Risk of Breast Implant Complications

Nguyen served as the lead author in the study, “Association Between Atopic Skin Disease and Implant-Related Complications in Breast Reconstruction,” which examined the likelihood of surgery complications among ≥ 20,000 women aged ≥ 18 years who had breast reconstruction after cancer surgery.2 The study compared breast implant complications, such as capsular contracture and implant rupture, in women with (n = 10,205) and without (n = 10,205) allergic skin conditions, including eczema or dermatitis.

Nguyen and colleagues sought to determine whether atopic skin diseases are linked to implant-related complications. Capsular contracture, one of the most common issues in implant-based breast reconstruction, has several established risk factors, including infection, radiation, and patient characteristics. Since patients with atopic conditions tend to have higher rates of inflammation, infection, and fibrosis, the team examined whether these diseases might increase the likelihood of complications after breast implant surgery; investigators calculated the complication risk at 1-, 2-, and 3-years post-operation.2

After 3 years post-surgery, patients with atopic skin disease were more likely to need implant removal or additional surgeries to address the complications. The study revealed that patients with atopic diseases had significantly greater risks of implant complications (risk ratio [RR], 1.2; P <.0001), capsular contracture at 2 and 3 years (RR, 1.2; P ≤.0005), and revision surgeries at 1, 2, and 3 years (RR, 1.1; P <.001), compared to those without atopic diseases. Implant removal risk was increased at 1, 2, and 3 years (RR, 1.2; P ≤.004), rupture risk increased at 2 and 3 years (RR, 1.4; P ≤.0457), and greater implant infection rates at 1, 2, and 3 years (RR, 1.2; P ≤.0009).2

“This multi-timepoint analysis underscores the value of comprehensive risk assessment to inform surgical planning and patient care,” investigators wrote.2

Atopic Diseases’ Impact on Bone Grafting Complications

The second study presented at ACAAI 2025, conducted by several of the same investigators, focused on the evaluation of atopic diseases’ impact on bone grafting complications.3 Lead author Joshua Wang, MS, a medical student at UTMB John Sealy School of Medicine, presented the poster, “Atopic Disease Is Associated with Increased Complications Following Bone Grafting: A Multicenter Retrospective Cohort Study.”

Using the TriNetX research network, this retrospective study compared patients with documented bone grafting procedures and prior atopic disease with patients without atopic disease. Participants were matched 1:1 based on demographics and comorbidities, with 19,334 patients in each arm.3

Wang and colleagues assessed postoperative outcomes at 90 days and 2 years. At 90 days, patients with atopic diseases demonstrated a greater risk of infection or wound complications (hazard ratio [HR], 1.19; 95% confidence interval [CI], 1.08 – 1.32), osteomyelitis (HR, 1.29; 95% CI, 1.12 – 1.48), and hardware removal (HR, 1.22; 95% CI, 1.05 – 1.41). At 2 years, patients with atopic disease continued to have an increased risk for infection or wound complications (HR, 1.20; 95% CI, 1.11 – 1.31), osteomyelitis (HR, 1.20; 95% CI=1.08 – 1.33), hardware removal (HR,1.21; 95% CI, 1.11 – 1.33), mechanical loosening (HR, 1.35; 95% CI, 1.17 – 1.56) and revision surgery (HR, 1.16; 95% CI, 1.09 – 1.25). The team observed no differences in graft failure, pathological fractures, surgical intervention/debridement, or opioid abuse among patients with and without atopic diseases.3

“Even two years after their initial surgery, people with atopic conditions were still more likely to have problems like infection or implant loosening,” Wang said in a statement.1 “These results suggest that allergic conditions can affect the body’s ability to heal after surgery — not just in the skin, but in the bones as well.”

References

1. People with allergies or eczema may face higher risk of surgical complications. EurekAlert! November 6, 2025. https://www.eurekalert.org/news-releases/1103542. Accessed November 24, 2025.

2. Nguyen P, Wang J, Pham A, et al. ASSOCIATION BETWEEN ATOPIC SKIN DISEASE AND IMPLANT-RELATED COMPLICATIONS IN BREAST RECONSTRUCTION. Poster presented at ACAAI 2025 in Orlando, Florida, from November 6 – 10.

3. Wang J, Nguyen P, Pham A, et al. ATOPIC DISEASE IS ASSOCIATED WITH INCREASED COMPLICATIONS FOLLOWING BONE GRAFTING: A MULTICENTER RETROSPECTIVE COHORT STUDY. Poster presented at ACAAI 2025 in Orlando, Florida, from November 6 – 10.