Piercings and General Anesthetic?

[Imadique]

Not strictly an SRS question but it seemed the best place to put it seeing as Dr Kunaporn is an SRS surgeon and he is the one I'm going to for BA and Orchie.

Has anyone had their surgeon demand they take out all their piercings before going under? Any experience with Sanguan Kunaporn specifically?

I've been assured by my piercer that all of mine are of a grade of metal that the concern is not relevant to them but I don't know if Dr. Kunaporn will take his word for it, I've exchanged a slew of emails with the Dr over the arrangements already and I feel he's getting sick of me asking so many questions...

Oh and before anyone says "just take them out anyway" it's only a concern for me because I have quite a few that are not easily removable (5 dermals + custom industrial) and they're all on my face so I'd want to arrange the piercer to remove them cleanly if I have to, rather than the Dr who might not have done it before.

Thanks,

            Sally

[Renate]

Hmm, I don't know about those kind of piercings at all, but it seems like surgeons want everything out.
I've never heard the rationale, but it might be that they don't want any hassle if they have to do an emergency MRI.
I've seen hair elastics rejected if they had a splice with a tiny metal ferrule.

[CaitJ]

Not strictly an SRS question but it seemed the best place to put it seeing as Dr Kunaporn is an SRS surgeon and he is the one I'm going to for BA and Orchie.

Has anyone had their surgeon demand they take out all their piercings before going under? Any experience with Sanguan Kunaporn specifically?

I've been assured by my piercer that all of mine are of a grade of metal that the concern is not relevant to them but I don't know if Dr. Kunaporn will take his word for it, I've exchanged a slew of emails with the Dr over the arrangements already and I feel he's getting sick of me asking so many questions...

Oh and before anyone says "just take them out anyway" it's only a concern for me because I have quite a few that are not easily removable (5 dermals + custom industrial) and they're all on my face so I'd want to arrange the piercer to remove them cleanly if I have to, rather than the Dr who might not have done it before.

Thanks,

            Sally

The issue with piercings (and any metal jewellery) is that they can cause flash-burns if they need to defrib you (shock your heart) during surgery. I took out all my piercings and put in medical glass or plastic retainers.
My SRS was done by Dr Suporn, the other Thai surgeon, and he asked that everything be taken out. Tongue piercings are especially important to take out completely (not even a retainer) because they can interfere with the intubation (air tube) - especially in an emergency.
So yeah, you're gonna have to take them out and put non-conductive (non-metal) retainers in where you can.
Or don't have surgery.

[Imadique]

Thanks for the quick replies, not what I wanted to hear but thanks anyway

Apparently the dermals are all G23 Titanium - 90% Ti, 6% Aluminium and 4% Vanadium - which is non conductive (heat or electricity), hypoalgetic, non magnetic and basically inert in every way so there's no concern about flash burns in case of defib. I've sent an email to Sanguan asking his permission to leave them in, not expecting him to say yes (he very well might have another good reason not to want them in there or just not give a crap and say no anyway) but I tried it anyway. Will update with his answer.

[lilacwoman]

another reason to remove everything is because the possibility of theft from the unconscious patient cannot be ruled out.
hospital literature usually states that they cannot be held responsible for loss of valuables.

[Imadique]

Answer?  You'll have to remove them.  Believe that.  And guess what?  The world won't shift it's axis if your piercings are out for a few hours.

Is the hostility necessary? Did I at any point intimate that it was going to be the end of the world? I said I know he'll probably say no but what's the harm in asking?

How about a bet? If they can stay in, you get your cheeks pierced. If they have to come out I'll Wear a t-shirt that says "Caution: Leprosy" to go with all the bloody swollen holes in my face at the airport.

[Mr.Hyde]

Ok, please relax. Let's calm this, ok?

@lilac, it's clear that you don't like piercings, but understand that there are people who like them, and asking them to put them off would trigger a feeling like "putting your own teeth off".
And, for the record, some of my pericings actually closed when I removed them for some dental healing. And it was like 5 or 6 hors without them, the piercings were like 1 year old....and they closed and I had to re-pierce...maybe I'm just like Wolverine, but I've heard of some people with same situation. I don't want to imagine the uncomfort of having to remove dermal piercings, so I see is a normal thing to have him concerned about.

@Imadique, I understand the hassle of having to remove dermal piercings. Their removal is difficult, and I understand that you want your piercier to remove them. You can ask him if it would be OK to put them again after surgery, he will give you the proffesional advice.
The most probably is that you have to take them off, please do it some time before surgery so your holes have time to cure before the surgery. 

Since I'm having my surgery late this month, I'm almost ready to remove mine...It is difficult to have to say goodbye to my snakebites, too, even if they're just some pieces of metal which have been everyday with you for several years

Good luck man, and I hope you can get them back!

[Renate]

Apparently the dermals are all G23 Titanium - 90% Ti, 6% Aluminium and 4% Vanadium - which is non conductive (heat or electricity)

Well, titanium is a metal. Let's do the math, shall we?

According to the Wikipedia article on titanium the electrical resistivity of titanium is 420 nano-ohms x meter.

We can calculate the resistance of a foot of 18 AWG titanium wire:

420 nano-ohms x meter x 1 foot / 18 AWG = 0.156 ohms

As a reality check, copper is 25 times more conductive and runs about 0.006 ohms per foot for 18 AWG wire.

The calculation of thermal conductivity is left as an exercise for the student.

[tekla]

Most surgeons and hospitals are pretty set on their rules.  Good luck convincing a doctor to change their mind.

[lilacwoman]

I doubt as anyone would see removing dermal piercings as being equivalent to pulling teeth.

[tekla]

I just thought it was national hyperbole day, which is, of course, the absolute best day of this, or any other year.

[CaitJ]

Apparently the dermals are all G23 Titanium - 90% Ti, 6% Aluminium and 4% Vanadium - which is non conductive (heat or electricity), hypoalgetic, non magnetic and basically inert in every way so there's no concern about flash burns in case of defib.

Sorry, but ALL metals are conductive. It's a property of metals.
However, that's not the sole reason for taking them out; I'll give you the complete list of reasons once my fiancé - who works in operating theatres - wakes up.

[CaitJ]

@Imadique, I understand the hassle of having to remove dermal piercings. Their removal is difficult, and I understand that you want your piercier to remove them. You can ask him if it would be OK to put them again after surgery, he will give you the proffesional advice.

All she needs to do is put in medical glass or plastic retainers after they are removed. The surgeon had no problem with me leaving a medical glass retainer in my nose piercing and a plastic retainer in my naval piercing (I took my tongue piercing out completely though - don't want to risk obstructing the airway).
It shouldn't be a big deal.

[Mr.Hyde]

I'm not sure about the existence of retainers for dermal piercings. I may be wrong, but as fas as I know, dermal piercings have just one one side of metal out, the other side is inside the skin, like implants. You cannot just "pull them off" as if it were any normal piercing. I'm not good at explaining this, but google images of it...I'm not an expert on dermals but I think that is way more difficult to remove than just unroll the ball or open the ring of a normal piercing.


Plus the teeth thing was just a way to talk, not entirely literal. 

[CaitJ]

I'll give you the complete list of reasons once my fiancé - who works in operating theatres - wakes up.

He says that any piercings around the face that might impede the oxygen or anaesthetic mask are a risk and MUST be removed. If you have that many piercings in your face, there's a good chance that they will be getting in the way.
Another risk is that metal piercings that get hot can ignite iodine or chlorhexadine, which will result in flash burns and/or fire.
Lastly, piercings are bacteria farms and are always an infection risk.

Them's the reasons.

[Imadique]

He says that any piercings around the face that might impede the oxygen or anaesthetic mask are a risk and MUST be removed. If you have that many piercings in your face, there's a good chance that they will be getting in the way.
Another risk is that metal piercings that get hot can ignite iodine or chlorhexadine, which will result in flash burns and/or fire.
Lastly, piercings are bacteria farms and are always an infection risk.

Them's the reasons.

Thank you, this is a much better reason than "because that's the way it's done".

I think there's a little bit of misunderstanding stemming from people not realising exactly what dermals are. As Mr. Hyde said, there are no retainers available for them, if they come out they need to be re-pierced but the success of re-piercing isn't guaranteed as the existing scar tissue from the last time can make it lean to one side or just push it out very quickly. That's why I was asking if it was completely necessary to take them out, it's not because I'm going to have a cry over my face being naked.

And yes, point taken that no metal is completely non-conductive but I would be interested to see a comparison of the heat and electricity conductivity of titanium vs. skin, I only had time to do a brief search and couldn't come up with the figures (I'm at work). Either way it's a moot point if there are other reasons to take them out, I would wager that titanium is relatively non conductive though in terms of risk factor compared to gold for example.  Like I said a few times, if it has to be done I'm fine with that, not asking for an exception to the rules just a better explanation.




Thank you to the people who replied with informative answers




For anyone who might have wanted to know what they are, the dermals are the ones in the neck and temple (2 on other side).

[CaitJ]

A little basic physics knowledge will tell you that the LESS electrically conductive a material is, the hotter it gets when current is passed through it.
i.e. copper generates little heat when current is passed through it, but a comparative amount of graphite produces a LOT of heat when current is passed through it. That's why we originally used less conductive materials for filaments in light bulbs - they got hot and glowed red.

So a less conductive material is actually more dangerous. Gold, platinum or copper is actually safer (though still not 100% safe and needs to be removed).

[Imadique]

A little basic physics knowledge will tell you that the LESS electrically conductive a material is, the hotter it gets when current is passed through it.
i.e. copper generates little heat when current is passed through it, but a comparative amount of graphite produces a LOT of heat when current is passed through it. That's why we originally used less conductive materials for filaments in light bulbs - they got hot and glowed red.

So a less conductive material is actually more dangerous. Gold, platinum or copper is actually safer (though still not 100% safe and needs to be removed).

Yeah I actually remember that now you bring it up and re-read my message from Joel (piercer) and he never said anything about heat at all, that was my stuff up.

Sanguans reply just came through, he's ok for me to leave them in, he's had patients with them before.

[CaitJ]

Sanguans reply just came through, he's ok for me to leave them in, he's had patients with them before.

Yay! 

[Siren]

I'm amazed at the aggressive tone of some posts in this thread.

Good to hear you got the answer you wanted in the end, Imadique.
My anaesthetist didn't require that I remove my labret for surgery, it was just covered over with a small piece of surgical tape.
He explained to me that their only concern was the risk of choking if the jewellery came undone.