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Be Prepared for Troublesome Tattoos, Problematic Piercings


 

EXPERT ANALYSIS FROM THE ANNUAL MEETING OF THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS

Systemic infections that have been seen from body piercings include tetanus, acute poststreptococcal glomerulonephritis, streptococcal septicemia, staphylococcal toxic shock syndrome, and pseudomonal abscesses.

Any piercing can cause a traumatic laceration, which may be sutured just like any other laceration, she said.

Some penile piercings can lead to paraphimosis, and without prompt treatment the tissue ischemia may cause gangrene and autoamputation of the distal penis. Urethral injuries, infections, prolonged priapism, and recurrent condyloma acuminatum are other risks from male genital piercing. Female genital piercings increase the risk for vaginal lacerations, sexually transmitted diseases, and urinary tract infections.

Dr. Rachel L. Chin

Remind any patients with genital piercings to use condoms for any sexual contact, and to be aware that condoms may be torn by the body jewelry, Dr. Chin said.

Learn how to remove the most common kinds of body piercing jewelry, she suggested. These include barbell studs, labret studs, and bead rings, which may be removed by unscrewing and/or pulling on parts of the jewelry. A captive bead ring is most easily removed using ring expanding pliers or external snap ring pliers.

Pearling is another body modification technique in which small objects of various materials are placed beneath the skin of the penis, hands, or other body parts. The risks and healing characteristics are similar to those of any subdermal implants, and rejection can occur but is rare. Migration of the implanted material is common, however, both during and after healing.

At Dr. Chin’s institution, it’s not uncommon to see problematic penis rings, in which a metal ring that the patient has placed over his penis to keep an erection becomes stuck and interferes with blood flow. "We call the fire department" to come cut off the ring, she said. These patients can’t be given too much sedation, because the room must be free of excess oxygen when the fire department’s saw sends sparks flying.

If you see this problem and your fire department won’t come, call the orthopedics department. "They have the right tools" for the job, she said.

Dr. Chin said she has no relevant conflicts of interest.

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