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Ear-piercing techniques as a cause of auricular chondritis
D R More1, J S Seidel, P A Bryan
1Department of Emergency Medicine, Harbor-UCLA Medical Center, Los Angeles, California, USA.
Objective:
To investigate the different methods of ear and body piercing as possible sources of infection, and to provide a brief literature review of infections resulting from high ear piercing as well as bacterial coverage of common disinfectants used as preparation agents.
Methods:
Two cases of auricular chondritis caused by Pseudomonas are presented. A survey of 14 businesses that pierce ears was conducted using a scheduled interview. Information regarding the type of piercing instrument, composition of earring, training of employees, anatomic placement of earrings, and preparation and aftercare of ears was obtained.
Results:
One hundred percent of the interviews attempted were completed. The cosmetic shops and earring kiosks both used hand-powered earring "guns" to pierce ears, while the tattoo parlors used sterile needles and forceps. All of the businesses interviewed used earrings composed of either 14K or 24K gold, stainless steel, and other piercing-grade metals. None of the businesses used earrings made of nickel. The cosmetic shops and kiosks used a combination of videos, demonstrations, and direct supervision to train employees but did not have a specified training period. The tattoo parlors required their employees to complete an apprenticeship training program of varying time lengths. All of the businesses pierced the lobe and cartilaginous portions of the ear. The cosmetic shops and kiosks used benzalkonium chloride or isopropyl alcohol as ear preparation agents, while the tattoo parlors used only iodine-based solutions. At all of the businesses, minimal aftercare instructions were given and they typically dealt with maintaining ear-hole patency.
Conclusion:
The cosmetic shops and earring kiosks used piercing methods that predisposed to auricular chondritis, such as poor training of employees and use of benzalkonium chloride as a preparation agent. Emergency physicians need to be aware of the severity of these types of infections, which often require surgical management and intravenous antibiotics covering Pseudomonas.
Insights
Ear and body piercing methods can lead to infections like auricular chondritis. Cosmetic shops and kiosks using specific disinfectants and training methods pose higher risks for Pseudomonas infections.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Dermatology
Background:
- Ear and body piercing are common procedures with potential infectious complications.
- Auricular chondritis is a severe infection that can result from ear piercing.
- Pseudomonas species are common pathogens in piercing-related infections.
Purpose of the Study:
- To investigate ear and body piercing methods as potential sources of infection.
- To review literature on infections from ear piercing.
- To assess the efficacy of disinfectants used in piercing procedures.
Main Methods:
- A survey of 14 ear-piercing businesses was conducted.
- Information on piercing instruments, materials, training, and aftercare was collected.
- Two cases of Pseudomonas-induced auricular chondritis were presented.
Main Results:
- Cosmetic shops and kiosks used "guns" and less effective disinfectants (benzalkonium chloride, isopropyl alcohol).
- Tattoo parlors utilized sterile needles/forceps and iodine-based disinfectants.
- Inadequate employee training and minimal aftercare instructions were noted across businesses.
Conclusions:
- Piercing methods in cosmetic shops/kiosks, including poor training and certain disinfectants, increase the risk of auricular chondritis.
- Emergency physicians must recognize the severity of these infections, often requiring surgical intervention and specific antibiotic treatment for Pseudomonas.
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