Introduction: Nuss procedure is the main reason for metal implants use by pediatric and thoracic surgeons. There is an ongoing debate on how to avoid allergic complications. Herein we describe our eight-year experience with systematic preoperative metal patch testing and our selective titanium bar use in Nuss procedure. Materials and Methods: Single center retrospective observational cohort study of patients who underwent the Nuss procedure from 2013 to 2020. Preoperative metal patch testing was done in all cases. Criteria for titanium bar utilization were: a positive test for a major component of the stainless-steel bar; or a positive metal patch test and a positive history of atopy, food or metal allergy, or previous allergic reaction to an implant or device. Results: 56 patients were included. Most were male (91.1%) with a median age of 15.0 [13.0-22.0] years old. 19.6% had a positive preoperative metal patch test and 54.5% of these had no personal history of atopy. Stainless-steel bars were used in 27.3% of those patients and titanium bars were used in 72.7%. One patient had a documented minor allergy reaction. None of the 56 patients required early bar removal. Conclusions: Our study suggests that routine preoperative allergy testing and a judicious use of titanium bar is safe and avoids metal allergic complications.

简介：Nuss 手术是儿科和胸外科医生使用金属植入物的主要原因。关于如何避免过敏并发症一直存在争论。在此，我们描述了我们在系统性术前金属补片测试方面的八年经验以及我们在 Nuss 手术中选择性使用钛棒的经验。材料和方法：对 2013 年至 2020 年接受 Nuss 手术的患者进行单中心回顾性观察队列研究。所有病例均进行术前金属斑片测试。钛棒使用的标准是： 不锈钢棒的主要成分检测呈阳性；或金属斑贴试验呈阳性，并且有过敏史、食物或金属过敏史，或既往对植入物或设备有过敏反应。结果：纳入 56 名患者。大多数为男性 (91.1%)，中位年龄为 15.0 [13.0-22.0] 岁。19.6% 的术前金属斑贴试验呈阳性，其中 54.5% 没有个人过敏史。其中 27.3% 的患者使用不锈钢棒，72.7% 的患者使用钛棒。一名患者有轻微过敏反应记录。56 名患者中没有一人需要提前移除钢筋。结论：我们的研究表明，常规术前过敏测试和明智地使用钛棒是安全的，可以避免金属过敏并发症。