Necrotising fasciitis and cellulitis after traditional Samoan tattooing: case reports.

Traditional Samoan tattooing, ta tatau, is a vital part of Samoan culture. It is being performed with greater frequency on New Zealand resident Samoans. Unfortunately, ta tatau has recently been the causal factor in two significant infectious cases, in one of which death resulted. The two cases were clinically reviewed. An investigation into the history and practice of ta tatau was made in an attempt to identify causal factors that could be addressed. The two cases had similar causal themes. These included improper sanitary techniques, ta tatau being performed in unlicensed premises by temporary tattooists, patients that were unwilling to access medical services due to the expectations of tradition, lack of follow-up and lack of infection advice by the tattooist. Life threatening infectious complications has not previously been described for traditional Samoan tattooing. Improper sanitary conditions in combination with late presentation to medical services have been suggested as the cause of these cases. The technique, tools, culture and trends are discussed and recommendations are made for reducing infectious complications.