title: Piercing and tattooing in patients with congenital heart disease: patient and physician perspectives.
abstract: OBJECTIVE
  The frequency and safety of ear piercing and tattooing were assessed in a group of children, adolescents, and adults with congenital heart disease (CHD). Also, a group of physicians who care for adolescents and adults with CHD were surveyed for opinions and experiences regarding piercing and tattooing.
  
  
  METHODS
  An eight-question survey was mailed to 445 patients (181 adults and 264 children) from one center. A different five-question survey was mailed to 176 physician members of the International Society of Adult Congenital Cardiac Disease.
  
  
  RESULTS
  The patient survey was completed by 152 of 445 (34%) patients (mean age +/- standard deviation 19.8 +/- 16.2 years; range 0.25-67 years). Eighty-eight of 152 (58%) patients were female. Ear piercing occurred in 65 of 152 (43%) patients (mean age 12.4 +/- 8.7 years; range 0.25-45 years). Prior to piercing, only 4 of 65 (6%) patients took antibiotics, but 15 of 65 (23%) had piercing-related infections. No patient had endocarditis. Infections occurred 1 week to 3 years after piercing. All were local skin infections. Tattoos were placed in 8 of 152 (5%) patients (median age 17.5 years; range 13-56 years). No antibiotic use or infections were reported in patients with tattoos. The physician survey was completed by 118 of 176 (67%) physicians. The majority of physicians did not approve of patients having piercing or tattooing performed. However, 60% of physicians believed that antibiotic prophylaxis is indicated for these procedures.
  
  
  CONCLUSIONS
  Despite the opinion of many physicians, most patients do not take antibiotic prophylaxis for piercing and tattooing. Patients apparently do not suffer serious sequelae. The efficacy of standard antibiotic regimes as applied to ear piercing and tattooing requires further study, since these procedures are increasingly popular in modern society.
authors: Section of Pediatric Cardiology and Adult Congenital Heart Disease Clinic, Loyola University Medical Center, Maywood, Illinois 60153, USA.
authors: F
authors: F
authors: Cetta
authors: L C
authors: LC
authors: Graham
authors: R C
authors: RC
authors: Lichtenberg
authors: C A
authors: CA
authors: Warnes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D003357:Cosmetic Techniques / Q000009:adverse effects*; D004431:Ear, External; D005260:Female; D006330:Heart Defects, Congenital; D006801:Humans; D007223:Infant; D007239:Infections / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011677:Punctures / Q000009:adverse effects; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013653:Tattooing / Q000009:adverse effects*