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Perichondritis after elective surgery
  1. N White
  1. Royal Free Hospital, Pond Street, Hampstead, London, NW3 2QG, UK; nickwhitedoctors.net.uk

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    I read with interest the description of perichondritis after ear piercing by Yahalom and Eliashar.1 As well as the increasing incidence of perichondritis after piercing of auricular cartilage, it can also be a problem after elective surgery. Correction of prominent ears (otoplasty/pinnaplasty) is a procedure that can be carried out in the UK within the NHS on patients under the age of 16. It involves exposure and scoring of the auricular cartilage to reconstruct the antehelical fold or concha.2 Although the complication rate is low, 2%–4% of cases become infected and a few of these progress to perichondritis.3

    Its treatment is primarily antibiotics and surgical debridement but this is complicated due to restrictions on prescribing ciprofloxacin to children. The long term outcome of these cosmetic procedures can be seriously affected by infection. Scrupulous aseptic technique and a single perioperative dose of prophylactic antibiotics are used to prevent this problem in elective surgery, and while aseptic conditions are recommended in ear piercing antibiotic cover is not.

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