title: Surgical skin-marking techniques.
abstract: Surgical skin-marking inks and dyes are in everyday use for designing and planning incisions in plastic and reconstructive surgery. We have traced the historical development of surgical skin-marking techniques from ancient times to the present. The biochemical characteristics of the commonly used marking agents are discussed. A three-part experiment utilizing a pig model was carried out to test the tissue inflammatory response to the various dyes and inks when used intradermally as tattoos, the persistence of such tattoos, and the ease of skin erasure for each of eight stains. Methylene blue and gentian violet are recommended as the best all-purpose marking agents. The use of proprietary inks is discouraged.
mesh_terms: D000818:Animals; D004396:Coloring Agents / Q000009:adverse effects / Q000266:history; D013502:General Surgery / Q000266:history; D005840:Gentian Violet; D049668:History, 15th Century; D049669:History, 16th Century; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D007249:Inflammation / Q000209:etiology; D008751:Methylene Blue; D000644:Quaternary Ammonium Compounds; D012867:Skin; D012871:Skin Diseases / Q000209:etiology; D013194:Staining and Labeling / Q000009:adverse effects / Q000379:methods*; D013518:Surgery, Plastic / Q000266:history / Q000379:methods*; D013552:Swine; D013653:Tattooing
chemical_list: D004396:Coloring Agents; D000644:Quaternary Ammonium Compounds; C006798:brilliant green; D005840:Gentian Violet; D008751:Methylene Blue