Managing and Preserving Tattoos During Orthopaedic Surgery.

Orthopaedic surgeons encounter tattoos in surgical fields with an increasing frequency and have the choice of avoiding, disregarding, bordering, or incorporating them into the surgical incisions. This article describes the history and the personal, social, and artistic value of tattoos; the physiology of tattoos and wound healing; the principles of incision planning for optimal cosmesis; and specific considerations when encountering tattoos in the surgical field. It subsequently describes cosmetic outcomes and tattoo-specific complications after surgery and provides a decision tree to help surgeons and patients decide the best approach for individual situations.