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Sindoni A, Valeriani F, Protano C, Liguori G, Romano Spica V, Vitali M, Gallè F. Health risks for body pierced community: a systematic review. Public Health 2022; 205:202-215. [PMID: 35339940 DOI: 10.1016/j.puhe.2022.01.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 01/20/2022] [Accepted: 01/23/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Body piercing is defined as the penetration of jewellery into openings made in different body areas. In the last decades, it has become increasingly common in the general population. The aim is to analyse the available literature about complications from body piercing for contributing to raise the awareness towards this issue and to plan and perform appropriate prevention interventions. STUDY DESIGN This is a systematic review. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to perform this systematic review; the protocol was registered with PROSPERO [CRD42020177972]. PubMed, Scopus and Web of Science were searched from database inception to April 2020, and articles in English language reporting a proven association between piercings and health risks were included, and their quality were assessed by adequate quality assessment tools. RESULTS A total of 4748 studies were found, and after duplicates removal and screening, 84 articles were included. Studies dealing with microbiological effects reported these complications both locally and at distant sites as a result of the spreading of the primary site infection: mastitis, endocarditis, glomerulonephritis, cephalic tetanus, viral hepatitis, HIV, cerebellar brain abscess and toxic shock syndrome. In addition, bleeding, gingival recession, dental injuries, contact dermatitis, granulomatous dermatitis, keloid, fibroma and basal cell carcinoma were reported. CONCLUSIONS Health authorities should promote educational campaigns to spread the knowledge on health risks related to piercings. Besides, piercers are often not adequately aware of all the possible adverse effects due to piercings because their professional training differs among countries. It is therefore advisable to provide periodical upgrade of their education in this field.
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Affiliation(s)
- A Sindoni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185, Rome, Italy.
| | - F Valeriani
- Department of Movement, Human, and Health Sciences, University of Rome Foro Italico, 00135, Rome, Italy.
| | - C Protano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185, Rome, Italy.
| | - G Liguori
- Department of Movement Sciences and Wellbeing, University of Naples Parthenope, 80133, Naples, Italy.
| | - V Romano Spica
- Department of Movement, Human, and Health Sciences, University of Rome Foro Italico, 00135, Rome, Italy.
| | - M Vitali
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185, Rome, Italy.
| | - F Gallè
- Department of Movement Sciences and Wellbeing, University of Naples Parthenope, 80133, Naples, Italy.
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Sosin M, Weissler JM, Pulcrano M, Rodriguez ED. Transcartilaginous ear piercing and infectious complications: a systematic review and critical analysis of outcomes. Laryngoscope 2015; 125:1827-34. [PMID: 25825232 DOI: 10.1002/lary.25238] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2015] [Indexed: 11/05/2022]
Abstract
OBJECTIVES/HYPOTHESIS The purpose of this systematic review was to critically analyze infectious complications and treatment following transcartilaginous ear piercing. DATA SOURCES MEDLINE Pubmed database. REVIEW METHODS A MEDLINE PubMed database search using free text, including "ear chondritis," "ear perichondritis," "ear cartilage piercing," and "auricle piercing," yielded 483 titles. Based on set inclusion and exclusion criteria, the titles, abstracts, and full text articles were reviewed for inclusion and underwent data extraction. Pooled outcomes are reported. RESULTS A total of 29 articles met inclusion criteria, including 66 patients. The mean age of the patients was 18.7 ± 7.6 years (range: 11-49), 87.5% female. Ear deformity was more likely to occur following postpiercing perichondritis of the scapha 100% versus the helix 43% (P = 0.003). Mean duration of symptoms prior to patients seeking medical attention was 6.1 ± 4.1 days. Greater than 5 days of symptoms prior to seeking treatment was significantly more likely to result in hospitalization. Pseudomonas aeruginosa accounted for 87.2% infections. Of the patients with Pseudomonas, 92.3% were hospitalized versus 75% of the patients infected with Staphylococcus aureus. Initial oral antibiotics prescribed did not target the cultured bacterium in 53.3% of cases; of these, 87.5% were hospitalized. CONCLUSIONS Transcartilaginous postpiercing infection may lead to ear deformity and hospitalization. Patients (customers) and practitioners must be aware of optimal treatment strategies to minimize associated morbidity. Scapha piercing and delay in presentation are associated with poorer outcomes. Pseudomonas is the most common bacterial infection. Initial antibiotic selection must be optimized accordingly.
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Affiliation(s)
- Michael Sosin
- Department of Plastic Surgery, Institute of Reconstructive Plastic Surgery, New York University Langone Medical Center, New York, New York.,Department of Surgery, Medstar Georgetown University Hospital, Washington, DC, U.S.A
| | - Jason M Weissler
- Rutgers Robert Wood Johnson University Hospital, New Brunswick, New Jersey
| | - Marisa Pulcrano
- Georgetown University School of Medicine, Washington, DC, U.S.A
| | - Eduardo D Rodriguez
- Department of Plastic Surgery, Institute of Reconstructive Plastic Surgery, New York University Langone Medical Center, New York, New York
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Pinna abscesses: can we manage them better? A case series and review of the literature. Eur Arch Otorhinolaryngol 2014; 272:3163-7. [DOI: 10.1007/s00405-014-3346-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 10/15/2014] [Indexed: 10/24/2022]
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Piercing associated perichondritis of the pinna: are we treating it correctly? The Journal of Laryngology & Otology 2013; 127:505-8. [DOI: 10.1017/s0022215113000248] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:This paper reports a series of patients with sporadic pinna perichondritis who presented to a district general hospital over a period of 10 years. The data examined included the causative organism, risk factors and pattern of antibiotic use.Method:A retrospective analysis of diagnosed cases of pinna perichondritis from 2001 to 2012 was performed. A literature review of pinna perichondritis was carried out using Pubmed with the key words ‘pinna perichondritis’, ‘pinna abscess’, ‘pinna infection’ and ‘piercing’.Results:Pinna perichondritis was more likely to result from chondral than lobe piercings. The majority of cases were caused byPseudomonas aeruginosa.Conclusion:Most patients were not prescribed anti-pseudomonal antibiotics on presentation. This may result in persistent infection and long-term cosmetic defects.
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Effective, simple treatment for perichondritis and pinna haematoma. The Journal of Laryngology & Otology 2009; 123:1246-9. [PMID: 19566972 DOI: 10.1017/s0022215109005635] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:To describe a new treatment for perichondritis and haematoma of the pinna. At present, the existing treatment for these conditions is initially medical (which usually fails), followed by surgery (incision, drainage and compression to prevent recurrence) with accompanying medical management. However, the result is often a failure, resulting in partial or complete ‘cauliflower ear’ deformity.Procedure:The described treatment involves draining the site of infection and irrigating with streptomycin solution. The cavity is then filled with a solution of streptomycin, hyaluronidase and triamcinolone.Result:The described treatment avoids the conventional surgical procedure, which is cumbersome for surgeons and harrowingly painful for patients.Conclusion:The new treatment may be recommended for universal use.
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Abstract
Body piercing has become a fashionable trend in western culture. High ear piercing is common among the adolescent population and complications from this procedure although uncommon can be permanently disfiguring. We describe a case of perichondritis after high ear piercing in an adolescent male. A review of the history of body piercing, complications, risk factors, and treatment is presented.
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Affiliation(s)
- Gail M Stewart
- Division of Pediatric Emergency Medicine, The Department of Emergency Medicine, Loma Linda University Medical Center and Children's Hospital, Loma Linda, CA, USA.
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Nedbalski TR, Laskin DM. Loss of a Sewing Needle in the Tongue During Attempted Tongue Piercing: Report of a Case. J Oral Maxillofac Surg 2006; 64:135-7. [PMID: 16360871 DOI: 10.1016/j.joms.2005.09.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2005] [Indexed: 11/28/2022]
Affiliation(s)
- Terrence R Nedbalski
- Department of Oral and Maxillofacial Surgery, Virginia Commonwealth University School of Dentistry, Richmond, VA 23298-0566, USA
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MacLeod TM, Adeniran S. An unusual complication of penile piercing: a report and literature review. ACTA ACUST UNITED AC 2004; 57:462-4. [PMID: 15191831 DOI: 10.1016/j.bjps.2003.12.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2003] [Indexed: 11/28/2022]
Abstract
Body piercing has been practiced for many centuries and is thought to have its origins in the Hindu religion. As traditional ear piercings have given way to more adventurous anatomical sites, so too have the associated complications of these practices. We present the case of a 35 year old man who presented 12 months after a penile piercing with an extensive fistula of the glans penis resembling an acquired glanular hypospadius.
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Affiliation(s)
- T M MacLeod
- Department of Plastic Surgery, Derriford Hospital, Plymouth PL6 8DH, UK.
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Abstract
In recent years, high ear-piercing and wearing earrings in the cartilaginous region of the auricle have become popular. The frequent occurrence of subsequent complications also has been pointed out. The present case is of a 17-year-old girl with an auricular deformity caused by infections occurring after piercing in the scapha. The authors performed an auriculoplasty by excision of the deformed cartilage and autologous cartilage graft from the ipsilateral concha. At present, 1 year and 5 months after the operation, no sign of recontracture is noted, and the auricle remains in a gratifying shape.
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Affiliation(s)
- Naoshige Iida
- Department of Plastic and Reconstructive Surgery, Akita Red Cross Hospital, Kamikitate, Akita, Japan
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Abstract
The desire to modify a person's outer appearance is a phenomenon that can be traced back to the beginning of humankind. Body modifications have been practiced among all cultures around the globe to differing extents. The authors present medical complications through jewelry in a series of 35 consecutive patients. Patient charts were evaluated for age, gender, type and sequelae of injury, complications, and treatment results. The male-to-female ratio was 1:2.2. Most of the recorded complications were related to the new vogue of piercing, with the ear affected most commonly. Usually the complications were minor; however, 2 patients sustained disfiguring damage to their auricular cartilage as a result of high ear piercing, a child nearly asphyxiated on an aspirated earring, and 2 patients experienced severe dysphagia as a result of tongue piercing. The most severe complication was a lethal strangulation injury in a female patient whose necklace got trapped in the headrest of her car seat during a front-end collision.
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Affiliation(s)
- Benedikt J Folz
- Department of Otolaryngology, Head and Neck Surgery, Philipps-University Marburg, Deutschhausstrasse 3, D-35037 Marburg, Germany
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Cicchetti S, Skillman J, Gault DT. Piercing the upper ear: a simple infection, a difficult reconstruction. BRITISH JOURNAL OF PLASTIC SURGERY 2002; 55:194-7. [PMID: 12041970 DOI: 10.1054/bjps.2001.3799] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Piercing the upper ear to retain jewellery is now commonplace. When infection ensues, devastating chondritis leads to collapse of the ear. To our knowledge, the surgical reconstruction of post-piercing deformities has not been documented in the literature. We present five such cases referred for autogenous-tissue ear reconstruction. In four of these, the destroyed segments of ear cartilage were replaced with a carved costal-cartilage framework. One patient declined surgery. The importance of preventing infection is stressed.
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Affiliation(s)
- S Cicchetti
- Department of Plastic and Reconstructive Surgery, Mount Vernon Hospital, Northwood, UK
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Hanif J, Frosh A, Marnane C, Ghufoor K, Rivron R, Sandhu G. Lesson of the week: "High" ear piercing and the rising incidence of perichondritis of the pinna. BMJ (CLINICAL RESEARCH ED.) 2001; 322:906-7. [PMID: 11302908 PMCID: PMC1120071 DOI: 10.1136/bmj.322.7291.906] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- J Hanif
- Ear, Nose, and Throat Department, University Hospital of Wales, Cardiff CF14 4XW, UK.
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Abstract
OBJECTIVE To review the current information on medical complications, psychological implications, and legislative issues related to body piercing, a largely unregulated industry in the United States. METHODS We conducted a MEDLINE search of English language articles from 1966 until May 1998 using the search terms "body piercing" and "ear piercing." Bibliographies of these references were reviewed for additional citations. We also conducted an Internet search for "body piercing" on the World Wide Web. MAIN RESULTS In this manuscript, we review the available body piercing literature. We conclude that body piercing is an increasingly common practice in the United States, that this practice carries substantial risk of morbidity, and that most body piercing in the United States is being performed by unlicensed, unregulated individuals. Primary care physicians are seeing growing numbers of patients with body pierces. Practitioners must be able to recognize, treat, and counsel patients on body piercing complications and be alert to associated psychological conditions in patients who undergo body piercing.
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Affiliation(s)
- L M Koenig
- Department of Medicine, University of Wisconsin, Madison, WI 53792, USA
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Affiliation(s)
- A Landeck
- Department of Medicine, Cook County Hospital, Chicago, Illinois, USA
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Abstract
PURPOSE Despite growing interest in cosmetic piercing, a detailed evaluation of associated medical complications is lacking. MATERIALS AND METHODS A questionnaire addressing ear, nose, and other body parts piercing was anonymously presented to 1,000 nurses at a major Midwestern teaching hospital, and responses were obtained from 552. RESULTS One hundred sixty (35%) of the 452 nurses who had an ear pierced reported a complication. Three hundred fifty-five (30%) of the 1,200 total pierced sites developed complications that included minor infection (77%), allergic reaction (43%), keloid (2.5%), and traumatic tear (2.5%). The complication rate from piercing through cartilage (32%) was not significantly different from that found when piercing through soft tissue (29%). The type of complications experienced differed in frequency between cartilage and soft tissue, with minor infection being more prevalent in cartilage piercing (30% v 21%; P < .10) and allergic reaction found more frequently in soft tissue piercings (13% v 4%; P < .025). CONCLUSION This study identifies a low prevalence of major complications (<1%) and a relatively high prevalence of minor complications (30%) associated with ear piercing. The expected increase in complications and morbidity of piercing through cartilage was not found in this study.
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Affiliation(s)
- T C Simplot
- Department of Otolaryngology, University of Minnesota, Minneapolis 55455, USA
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Affiliation(s)
- R Staley
- Division of Adolescent Medicine, Children's Hospital Medical Center of Akron, Akron, OH 44308-1062, USA
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