Body piercing medical concerns with cutting-edge fashion

Need for improved public health protection of young people wanting body piercing: evidence from a look-back exercise at a piercing and tattooing premises with poor hygiene practices, Wales (UK) 2015

Following a cluster of serious pseudomonas skin infections linked to a body piercing and tattooing premises, a look-back exercise was carried out to offer clients a screen for blood-borne viruses. Of those attending for screening 72% (581/809) had a piercing procedure in the premises of interest: 94 (16%) were under 16 years of age at the time of screening. The most common site of piercing was ear (34%), followed by nose (27%), nipple (21%) and navel (21%). A small number (<5) tested positive for hepatitis B and C, with no evidence this was linked to the premises. However, 36% (211/581) of clients reported a skin infection associated with their piercing. Using data from client forms, 36% provided a false age. Those aged under 16 years (OR 4.5, 95% CI 2.7-7.7) and those receiving a piercing at an intimate site (OR 2.1, 95% CI 1.3-3.6) were more likely to provide a false age. The findings from this exercise were used to support the drafting of the Public Health (Wales) Bill which proposed better regulation of piercing premises and the need to provide proof of being 18 years of age or over before having a piercing of an intimate site.

Thermic effect on metal body piercing by electrosurgery: An ex vivo study on pig skin and bovine liver

BACKGROUND

Piercings are placed at different body sites often invisible to medical staff. They may cause additional injuries in trauma and emergency surgery by electro-cautery.

OBJECTIVE

To clarify whether electrosurgery will have a direct damaging effect to the skin around a pierced skin area.

METHODS

Metallic piercings were fixed at defined distances from the neutral and active electrode on abdominal pig skin. The distance of the active electrode was reduced by 5 mm increments to 0. The respective increases in temperature were determined with a thermal camera. A macroscopic and histological analysis of the area around the piercing to detect thermal damage was carried out.

RESULTS

Significant increases in temperature and visible changes in the tissue around the piercing only occurred when the active electrode was in direct contact with the piercing (increase of 47.3∘C). Electro-cautery in distance of 5 to 10 mm to the piercing showed only temperature increases of less than 5∘C.

CONCLUSIONS

If metallic piercings are not directly touched by the active electrode and the distance is more than 5-10 mm, no clinically relevant effect is created on the tissue in direct proximity to the piercings by electro-cautery. In an emergency surgery situation, a piercing not fixed in direct proximity to the surgical field may likely be ignored.

Adolescent and Young Adult Tattooing, Piercing, and Scarification

Tattoos, piercing, and scarification are now commonplace among adolescents and young adults. This first clinical report from the American Academy of Pediatrics on voluntary body modification will review the methods used to perform the modifications. Complications resulting from body modification methods, although not common, are discussed to provide the pediatrician with management information. Body modification will be contrasted with nonsuicidal self-injury. When available, information also is presented on societal perceptions of body modification.

Fibrous Histiocytoma-like Spindle-Cell Proliferation in the Nipple After Body-Piercing

We report the case of a 19-year-old pregnant woman who presented with a nipple tumor. The lesion consisted in a spindle-cell proliferation with histologic features similar to those of fibrous histiocytoma, with a highly vascularized stroma. Although it showed low mitotic activity, scattered marked atypical cells with prominent nucleoli were identified, thus raising concern about the benign nature of the tumor. Immunohistochemical evaluation revealed that the spindle cells were diffusely positive for vimentin, focally positive for CD68, and negative for all the other tested antibodies. The patient had a total excision of the lesion and she is free of disease after 30 months. To our knowledge this is the first reported case of a lesion of this type in the nipple after body-piercing.

Tattooing, Piercing, Healthy Behaviours and Health Value

This study was designed to investigate whether people who engage more frequently in healthy behaviours, and attach a higher value to health, are likely to engage less frequently in tattooing and piercing. One hundred and eight participants with tattoos and/or piercings completed questionnaires including the Reported Health Behaviours Checklist and the Health Value Scale. There were no significant relationships between healthy behaviours, health value and numbers of tattoos or piercings. A significant proportion of pierced and tattooed participants had not considered possible health risks, and those that had were often unaware of potentially serious health problems. Results are discussed in terms of health guidelines for tattooing and piercing.

Caring for Surgical Patients With Piercings

Body piercing, a type of body modification that is practiced in many cultures, creates an unnatural tract through tissue that is then held open by artificial means. Today, professional body piercing is often performed in piercing establishments that are subject to dissimilar forms of regulation. The most frequently reported medical complication of body piercing and similar body modifications, such as dermal implantation, is infection. Patients with piercings who undergo surgery may have additional risks for infection, electrical burns, trauma, or airway obstruction. The published research literature on piercing prevalence, complications, regulations, education, and nursing care is outdated. The purpose of this article is to educate nurses on topics related to nursing care for patients with piercings and similar body modifications, including the history, prevalence, motivations for, and perceptions of body piercings as well as possible complications, devices used, locations, healing times, regulations, patient education, and other health concerns.

Critical urologic skills and procedures in the emergency department

The evaluation and management of genitourinary emergencies is a fundamental component of the training and practice of emergency physicians. Urologic procedures are common in the emergency room. Emergency physicians play a vital role in the initial evaluation and treatment because delays in management can lead to permanent damage. This article discusses the most common urologic procedures in which emergency physicians must be proficient for rapid intervention to preserve function and avoid complications. An overview of each procedure is discussed as well as indications, contraindications, equipment, technique, and potential complications.

Just a personal thing? A qualitative account of health behaviours and values associated with body piercing

Objectives:

This study investigates the perceptions of individuals with body piercings in relation to health behaviours and values specifically taking into account piercing location.

Methods:

A qualitative study that employed a series of in-depth, semi-structured individual interviews using thematic analysis to analyse data. Nine individuals with a range of piercings were recruited and semi-structured interviews were carried out in a West Midlands piercing studio.

Results:

The analysis identified themes relating to the presence of body piercings that included a range of health-related outcomes such as physical appearance, health behaviours, addiction and impressions. A possible relationship between oral piercings and ‘crash dieting’ was also identified.

Conclusions:

The results suggest that from the comments made the presence of body piercings is not related to any particular health concern, which is instead comparable to the general population. These results contradict previous studies citing a relationship with high-risk health behaviours. Further large-scale studies examining these findings are warranted.

Ultimate Answers to Proximate Questions: The Evolutionary Motivations behind Tattoos and Body Piercings in Popular Culture

Numerous studies have found that piercing and tattooing the body is an increasingly prevalent trend in modern popular culture; however, this is not only a modern practice. Evidence of various forms of body ornamentation has been found in human societies dating back thousands of years. Although prior research has focused on the potential relationships between various personality traits and the likelihood of piercing or tattooing the body, few have approached this topic from an evolutionary perspective. For instance, the general motivations for getting tattoos and piercings have tended to fall into the same three categories for hundreds of years: (a) a symbol of an important past event, love, or friendship, (b) group membership, and/or (c) a marker of individuality. We argue that these motivations are simply proximate behaviors for an ultimate evolutionary reason: the perpetuation of one's genes. In this article, we propose two new theories about the origins of body ornamentation. First, in our “human canvas” hypothesis, we propose a link between body ornamentation and the human species' historical use of symbolic thought. Second, in our “upping the ante” hypothesis, we suggest that the steady rise in popularity of tattooing and piercing in Western culture has come about due to larger population densities and advancements in healthcare, which has led individuals to seek new and unique displays of fitness (i.e., body ornamentation). We then conclude with proximate examples in popular culture to display the proposed ultimate evolutionary reasoning behind body ornamentation.

Septic shock after posterior spinal arthrodesis on a patient with Scheuermann kyphosis and multiple body piercings

STUDY DESIGN

A case report.

OBJECTIVE

We report septic shock as postoperative complication following an instrumented posterior spinal arthrodesis on a patient with multiple body piercings. The management of this potentially catastrophic complication and outcome of treatment is been discussed.

SUMMARY OF BACKGROUND DATA

Body piercing has become increasingly more common because of change in culture or as a fashion statement. This has been associated with local or generalized ill effects including tissue injury, skin and systemic infections, and septic shock. There is no clear guideline pathway regarding removal and reinsertion of body piercings in patients who undergo major surgery. Complications following orthopedic or spinal procedures associated with body piercing have not been reported.

METHODS

We reviewed the medical notes and radiographs of an adolescent patient with Scheuermann kyphosis and multiple body piercings who underwent a posterior spinal arthrodesis and developed septic shock.

RESULTS

Septic shock developed on postoperative day 2 after reinsertion of all piercings following the patient's request. The patient became systemically very unwell and required intensive medical management, as well as a total course of antibiotics of 3 months. The piercings remained in situ. She did not develop a wound infection despite the presence of bacteremia and spinal instrumentation. The patient had no new piercings subsequent to her deformity procedure. Two and a half years after spinal surgery she reported no medical problems, had a balanced spine with no loss of kyphosis correction and no evidence of nonunion or recurrence of deformity.

CONCLUSION

The development of septic shock as a result of piercing reinsertion in the postoperative period has not been previously reported. This is an important consideration to prevent potentially life-threatening complications following major spinal surgery.

Inflammatory and Immunitary Modifications in Saliva of Subjects with Labial and Tongue Piercing

Piercing is the practice of puncturing some parts of the body, including the area of the stomach, to apply ornamental objects. The presence of oral and perioral piercings are a risk factor for numerous acute and chronic complications, such as chipping of the dental enamel, lesions of the gums and infection. The presence of piercings in the oral cavity may also act as a stimulant for inflammation and determine modifications in the components of the saliva. The aim of this study is to evaluate whether there is a variation in the inflammatory or immunitary components of the saliva of adult patients with labial and tongue piercings. Twenty-five adult patients were examined (11 males and 14 females with an average age of 23.4±3.6 years) who had had a minimum of one labial or tongue piercing for at least 1 year. A questionnaire was compiled for each patient and the composition of the saliva was examined, before and for the 72 hours after removal of the piercings. The data was analyzed using the student's t-test for independent samples and the level of significance was placed at p< 0.05. The examination of the saliva showed a statistically significant increase (p< 0.05) of interleukin-1 and −8, of lysozyme and amylase. A more basic value of pH (p< 0.05) was also found and a decrease in the immunoglobulins, in particular of IgA (p< 0.05). After the removal of the piercings, the parameters of the saliva returned to the reference values, with the exception of the immunoglobulins, whose values remained the same as in the first saliva examination. The presence of piercings in labial areas or in the tongue is accompanied by chronic inflammation in the components of the saliva, with an increase in the level of the interleukins. Furthermore, in patients who have had an oral piercing for a longer period, the level of interleukins is even higher. This inflammatory situation, however, may recede in a few days after the removal of the irritating agent. Labial or tongue piercings also determine an increase in the flow of saliva, an increase in saliva enzymes, of lysozyme in particular, and a more basic pH value.

Body piercing complicated by atypical mycobacterial infections

Body piercing is a growing trend, especially in young people, but the literature on complications of piercing consists mostly of case reports involving ear piercing. Previous reported complications of piercing include contact dermatitis, keloids, traumatic tearing, viral transmission, and bacterial infections. We report two patients who presented with atypical mycobacterial infections of body piercing sites. It is important to recognize the association of piercing and mycobacterial infections so that tissue can be obtained for histopathologic examination and appropriate culture.

The hole picture: risks, decision making, purpose, regulations, and the future of body piercing

Can it be said that body piercing is ubiquitous, found across all socioeconomic groups? The major concentration is among adolescents and young adults 15 to 30 years old, in some studies, 50% of the population. Commonly identified physical risks are bleeding, tissue trauma, and bacterial infections; psychosocial risks are unhappiness, low self-esteem, and disappointment. The Health Belief Model is used to explain decision making; purposes for body piercing consistently center on personal expression (self-identity) and uniqueness. The international and US body piercing regulations are discussed, leading to the need for tracking complications globally and standardization of regulations. Proactive health education for clients and health providers remains a priority.

Adverse consequences of tattoos and body piercings

Body piercings and tattoos are becoming more common in the adolescent population today. Despite their movement into mainstream society, literature to aid in counseling of teens about these issues is scant. The practitioner dealing with this population of patients must be armed with the information necessary that will help adolescents make informed decisions about tattoos and piercings.

Dental and oral complications of lip and tongue piercings

Piercing of the tongue and perioral regions is an increasingly popular expression of body art, with more patients coming in for a routine check-up with tongue and/or lip piercings. Several complications of oral piercing have been reported, some of which are life-threatening. In the present clinical survey the prevalence of both tongue and lip piercing complications in oral health was assessed in a group of 50 patients. The most common dental problem registered was chipping of the teeth, especially in association with tongue piercing. Gingival recession was seen as a result of lip piercing with studs. Post-procedural complications included oedema, haemorrhage and infection. Therefore, dentists and oral and maxillofacial surgeons should be given more authority to advise patients with oral and facial piercings or those who plan to acquire this type of body art.

Victim of fashion: Endocarditis after oral piercing

A case report of endocarditis after tongue piercing is presented. Body piercing is a form of self-expression that is achieving greater acceptance and wider practice in modern society. Even in healthy individuals, significant health risks exist with this type of physical adornment. Despite this fact, no significant regulatory mechanisms are currently in place to guide practitioners of this craft or to protect the recipients of body piercing. Medical professionals should join the American Dental Association in their opposition of the practice of intraoral/perioral piercing and should call for the development of legislation protecting the recipients of such practices, particularly the population of young people in whom this type of body art is becoming increasingly prevalent.

Body piercing: issues and challenges for nurses

To provide safe and effective care for patients with body piercings, nurses must become more knowledgeable about this increasingly common practice. Competent nursing care is more than simply noting the presence or absence of body piercings, but includes accurate assessment, cultural sensitivity, and related patient education. Body piercings can create treatment challenges during trauma or post-assault care. An increased awareness of the history of body piercing, the piercing process, care of piercings, (including related wound care), and issues related to patient education, can enhance comprehensive nursing care.

Body Piercing Affecting Laparoscopy: Perioperative Precautions

Piercing is an increasingly popular fashion trend mainly among adolescents. Umbilical piercing in particular can cause perioperative problems during laparoscopic procedures. We describe how to deal with this fashion trend in our institutions. First, any piercing needs to be documented during preoperative physical examination. During preoperative informed consent, patients are told that all pierced jewelry needs to be removed, preferably by the patient before the procedure. For the operation, patients may be offered the use of sterile "sleepers," which are substitutes made of plastic to avoid closure of the wound canal perioperatively. Postoperatively, most pierced jewelry can be put back into position after anesthesia has completely worn off. Only jewelry for piercings close to wounds (e. g., navel piercings) should not be reinserted until the skin is closed. Careful observation and increased hygienic effort to prevent local infection is necessary. To date, we have not seen any severe umbilical infection after laparoscopy. However, in several patients the umbilical pierced jewelry was back in the navel on the same day of surgery, sometimes immediately after waking from anesthesia. Hospital staff should know how to remove and substitute piercing jewelry as well as how to optimize hygienic care perioperatively to prevent umbilical wound infections. Time and effort for patient teaching and hygienic care are slightly increased.

Body piercing: a patient safety issue

Body piercing is a common form of self-expression around the world. Although a common practice among many cultures and age groups, there is very little published as to the care of the patient with body piercings in the perianesthesia setting. This article explores the type, site, care, and removal of body piercings in the preoperative setting. A focus on issues in the United States and New Zealand is provided.

[Infections caused by piercing and tattoos--a review]

Piercing, i.e. perforation of skin or mucous membranes in order to attach mostly metallic jewelery as well as multicolored skin tattooing have become more popular than ever before and a considerable number of (young) people practise these methods of body art which are supposed to increase the individuality. But there is a lot of side effects, among them especially infections. The most important bacteria cultivated from such patients are Staphylococcus aureus, group A streptococci and Pseudomonas aeruginosa. Viruses which can be transmitted by piercing or tattooing are especially hepatitis B virus and hepatitis C virus. Besides local bacterial infections also systemic infections (sepsis, endocarditis) occur. The main aspects of diagnostics, therapy and prevention are discussed.

Body piercing: medical consequences and psychological motivations

Body piercing is increasing in popularity around the world. In this review, I describe the history, origins, and peculiarities of various forms of body piercing, and procedures involved, variations in healing time, legal aspects and regulations, and complications and side-effects. I have also included a discussion of the motivation for and psychological background behind body piercing. In presenting research results, I aim to raise awareness of the many risks associated with body piercing. In presenting psychological data, I intend to create an understanding of the multifaceted and often intense motivations associated with body piercing, and, thus, to diminish any prejudices held by health professionals against people with piercings.

Haemophilus aphrophilus endocarditis after tongue piercing

Piercing invades subcutaneous areas and has a high potential for infectious complications. The number of case reports of endocarditis associated with piercing is increasing. We studied a 25-year-old man with a pierced tongue, who arrived at Memorial Health University Medical Center with fever, chills, rigors, and shortness of breath of 6 days' duration and had an aortic valvuloplasty for correction of congenital aortic stenosis.

Tattoos and body piercings as indicators of adolescent risk-taking behaviors

PURPOSE

This study assessed tattoos and body piercings as markers of risk-taking behaviors in adolescents.

METHODS

A 58-question survey, based on the 1997 Centers for Disease Control and Prevention Youth Risk Behavior Survey, was offered to all adolescent beneficiaries that came to the Adolescent Clinic. The survey contained standard Youth Risk Behavior Survey questions that inquire about eating behavior, violence, drug abuse, sexual behavior, and suicide. Questions about tattoos and body piercings were added for the purposes of this study.

RESULTS

Participants with tattoos and/or body piercings were more likely to have engaged in risk-taking behaviors and at greater degrees of involvement than those without either. These included disordered eating behavior, gateway drug use, hard drug use, sexual activity, and suicide. Violence was associated with males having tattoos and with females having body piercings. Gateway drug use was associated with younger age of both tattooing and body piercing. Hard drug use was associated with number of body piercings. Suicide was associated with females having tattoos and younger age of both tattooing and body piercing. Tattoos and body piercings were found to be more common in females than males.

CONCLUSIONS

Tattoos and/or body piercings can alert practitioners to the possibility of other risk-taking behaviors in adolescents, leading to preventive measures, including counseling. Tattoo and body piercing discovery should be an important part of a health maintenance visit to best direct adolescent medical care.

Prevalence of body art (body piercing and tattooing) in university undergraduates and incidence of medical complications

OBJECTIVES

To survey the prevalence of body art (body piercing and tattooing) in university undergraduate students and to determine the incidence of medical complications from these procedures.

SUBJECTS AND METHODS

Between February and May 2001, students were offered the opportunity to complete an anonymous, voluntary survey at the beginning of class or organizational meetings. The survey instrument requested information concerning body piercing and tattooing (current or removed) by body site, age, sex, height, weight, body mass index, undergraduate class, athletic status, and the occurrence of medical complications.

RESULTS

Four hundred fifty-four (94.4%) of 481 students completed the survey (14.7% of total campus enrollment). The prevalence of body piercing was 51%, and that of tattooing was 23%. The chi2 analysis showed female students were more likely to be pierced than males (P=.002); there was no significant difference in the prevalence of tattooing by sex. Male athletes were more likely to be tattooed than male nonathletes (P=.02). No relationships were shown between piercing/tattooing and age or measures of body somatotype. The incidence of medical complications of piercing was 17%, and these complications included bleeding, tissue trauma, and bacterial infections. Pierced navels were particularly prone to infection. There were no reported medical complications from tattooing. Eighteen percent of piercings (58/315) and 4% of tattoos (6/149) had been removed.

CONCLUSIONS

Body art is prevalent among undergraduate university students, and there is a significant incidence of medical complications among students with piercing. Male athletes were significantly more likely to be tattooed than male nonathletes.

Fibrous umbilical polyp: a distinct fasciitis-like proliferation of early childhood with a marked male predominance

Benign fibrous lesions of the umbilicus have not been previously studied in a formal series. Clinical and pathologic findings were reviewed in all patients under age 19 with lesions resected from the umbilical region at Children's Hospital (Boston, MA, USA) during an 8-year period. Fourteen lesions were characterized by a well-circumscribed dome-shaped or pedunculated dermal proliferation of moderately cellular fibrous tissue without significant inflammation. Fibroblastic cells were plump to elongate with abundant pale pink cytoplasm. In a subset of lesions, some cells showed atypia or ganglion cell-like morphology. Collagen ranged from sparse to long narrow bundles. Vascularity was sparse and the lesions were nonencapsulated. Loss of rete ridges and basket-weave hyperkeratosis was common in the overlying epidermis. Immunostaining showed focal staining for muscle-specific actin and desmin in a subset of cases and no staining for cytokeratin, epithelial membrane antigen, CD34, or S-100. Age ranged from 3 to 18 months (mean 9 months, median 8 months). Thirteen (93%) patients were boys. Recurrence was not observed. In conclusion, the "fibrous umbilical polyp" is a distinctive lesion of early childhood with an uncertain pathogenesis. It shows a marked predilection for boys, is not rare, and appears to represent a clinicopathologic entity. Perhaps the umbilicus, a midline defect that is normally filled by dense scar tissue after birth, contains unique fibrogenic factors responsible for the development of this distinct lesion.

Tattooing, body piercing, and branding are on the rise: perspectives for school nurses

This journal presented the first nursing information on adolescents and tattooing 6 years ago, and 5 years ago, information was provided about body piercing. These were published to help school nurses assist adolescents become informed decision makers. Another purpose was to prevent risks and, if possible, help dissuade adolescents from tattooing and body piercing. Continuing this theme, the latest information and trends are reported and discussed, and new information on scarification and branding is presented. If an adolescent wants some form of body art (tattooing, body piercing, or branding), they will often obtain it regardless of regulations, risks, or money. School nurses can take a powerful, proactive role by sharing applicable information, realistic concerns, and care instructions about tattooing, body piercing, and branding. Specific information, risks, and care about each form of procedure is presented. A convenient reference table is available for nurses and students. Additionally, nursing actions are suggested including making changes in health policies regarding body art on a local and state level.

The risks of ear piercing in children

Body piercing, and particularly ear piercing is becoming increasingly common in young children who may not be capable of properly caring for the pierced site. This may result in infection at the site and embedding of the earring. Infection and the subsequent necessity of removal of such earrings can cause considerable pain and distress. There is also a proven risk of inducing nickel allergy in these children which can be a problem in later life. The potential for serious infection such as Hepatitis B, Hepatitis C and HIV is not appreciated by the parents of these children.

Body piercing: issues for A&E nurses

There has been a significant increase in the incidence of body piercing in the Western world over the last decade. Although some A&E nurses have piercings of one type or another themselves, many have no experience of it. When confronted with a patient who has a problem associated with a piercing, there can be difficulties. However, even more anxiety seems to arise in emergency situations, when speed is crucial and health care professionals are unsure about how or when to remove jewelery. This piece reviews literature and takes advice from a professional piercer, regarding issues facing A&E nurses and how they can best be approached. Handling trauma, infection and embedded jewelery is described. Specific detail about piercing of the ear, nose, tongue, nipple, navel and genitals is included. Finally the role of the A&E nurse is identified in: when and how to remove jewelery, aspects of health education and raising awareness among staff.