I 2003 Mé wrote a summary interpretation for my colleagues who were questioning a website recommending an instrument processing method that seemed unusual and unsafe. An peculiarity an modh seo ná go mbeadh tattoo agus piercing trealamh a autoclave [teas tais] processed roimh glanadh.

An achoimre

After researching the Unimax System and exploring the supposed benefits, I propose a safer solution for tattooists [agus piercers] would be to use pre-sterilized disposable [trealamh, mar shampla] feadáin agus réamh-sterilized snáthaidí-barraí, eliminating the need for a studio autoclave and the labor expense and risk for cleanup.

This appears on the surface very much a thoughtful and logical approach. The available scientific literature agrees with some of it in principle, particularly the statement though there are flaws based on several dangerous misconceptions. Cleaning contaminated tools is not possible for tattoo and piercing shops [leis an modh seo].

An locht is mó sa chóras:

[Tugann do chóras a] equipment only needs rinsing or wiping off with disinfectant cloth before heat is applied.

• Ní laghdaíonn sruthlú ach bhaint próitéiní, particularly after a long or messy procedure.
• Wiping tools with disinfectant leaves a chemical residue as well as the proteins which is corrosive to instruments and the autoclave itself.
• Nuair a rinsed nó wiped, equipment that is allowed to dry and have heat applied at the end of the work day compounds the difficulty of removing [coagulated] próitéiní.

Common bench top autoclaves are only capable of sterilizing clean or new equipment that does not have any sort of cavity, porosity, hollow spaces or tubes. A éighníomhach, type N gravity displacement sterilizer as shown and described in the Unimax system is not physically capable of cleaning the inner surfaces of the tattoo tubes reliably.

Próitéiní (endotoxins resistant teasa) Tá cócaráilte on and into scratched surfaces on tools, go háirithe feadáin.

Iarmhair Próitéin agus dúch taobh istigh barr tattoo

Iarmhair Próitéin agus dúch taobh istigh feadán tattoo

Iarmhair Próitéin agus dúch taobh istigh grip tattoo

Le haghaidh piercing, an céanna maidir, though new jewelry and equipment all can be sterilized in a type B vacuum or type S positive pressure flush process autoclave, mar a chuirtear síos sa doiciméad faoi iamh.

Mo thuairim phearsanta:

[Mé] don’t bother trying to reuse anything, the evidence has shown that no piercing or tattoo equipment can be reused reliably.

Rebuttal and discusson

Wes Woods Scríobh:

I disagree with the conclusions that tattoo and piercing should dispose of used contaminated equipment instead of re-processing them for re-use.

Ben Carruth, mo chomhghleacaí ó Taithí Piercing Scríobh:

Tá tú cinnte saor in aisce go n-aontaíonn leis na conclúidí. Mar sin féin, in order for that disagreement to have weight above and beyond a personal opinion, the argument must be refuted with the degree of care and precision with which it was made, which in this case means logically cogent presentation of principles and contextually appropriate citation of reference and research materials provided by international health agencies, taighdeoirí neamhspleácha, and health regulatory authorities. Specific examples of the inadequacies of the provided counter arguments will be provided in a point for point format.

Wes Scríobh:

An t-áitreabh agus na conclúidí pharsáil thíos dhiaidh fhrisnéise.

Argóint # 1

A. Scrios Endotoxin, inactivation or removal is the criteria for demonstrating the efficacy (iontaofacht) ar phróiseas steiriliú.

B. Ní Endotoxins a bhaint ag baint úsáide as sterilizers dí domhantarraingthe.

Conclúid: Nach bhfuil sterilizers dí Domhantarraingt iontaofa.

Argóint fhrisnéise # 1

An dhíghníomhú na spóir, Stearothermophilus, is the most widely accepted test for the efficacy of autoclave sterilization accepted by the CDC and OSHA not the removal or destruction of endotoxins. Depyrogenation is not a required level for an item to be considered sterile for medical tools and equipment. Argóint # 1, Premise Tá Bréagach, therefore the conclusion is not proved by the argument.

Ben Scríobh:

Is é seo an léirmhíniú ar an argóint, sa chás is fearr, an unintentional misrepresentation. Ag aon phointe is Endotoxin presence directly equated with the testing criteria for effective operation. The elimination of Endotoxins is a functional requirement of the terminal decontamination and sterilization process, as active endotoxin presence represents a potentially severe health risk. Níos tábhachtaí, the survival of endotoxin due to inappropriate processing indicates that more durable pathogens are potentially present: pyrogens and prions being of particular concern. [ASTM F748 Clúdaíonn an próiseas meastóireachta]

Spore testing is the most widely accepted means of determining the efficacy of sterilization equipment to perform within its defined parameters. Spore tests are conducted to make sure that the equipment is operating up to its defined parameters: deireadh a chur le endotoxins [roimh steiriliú] is a functional component of those parameters.

An cheist a bhfuil tábhacht bunscoile, áfach, is that which lies beyond the capabilities of the equipment in question. There is not a benchtop steam sterilization system in existence that has been rated for reliable destruction of pathogenic prions or blood-shielded enveloped viral Hepatitis C when used with methods that do not adequately remove soil such as the Unimax system. The capabilities of differing sterilization systems are closely and carefully defined, and it is the responsibility of the practitioner to use the equipment as it was designed to be used. The specific capabilities of a particular device must be assessed by a regulatory authority, cosúil leis an [FDA nó an] MDA sa Ríocht Aontaithe.

Wes Scríobh:

Argóint # 2

A. Bench top autoclaves can only sterilize clean or new equipment.

B.Clean nó trealamh nua ciallaíonn endotoxin saor in aisce.

C. Used tattoo and piercing equipment contain endotoxins.

Conclúid: Used tattoo and piercing equipment cannot be sterilized using a bench-top sterilizer.

Argóint fhrisnéise # 2

Clean means relatively free of gross contamination that would interfere with the sterilizing process. Tá sé ina ábhar céime, not an absolute. Clean does not mean the absence of endotoxins. Premise Tá bréagach, and premise B is false. Premise C is false unless there is some study that demonstrates that endotoxins are likely to be present. The conclusion is false because sterilization is measured by spore testing not endotoxin indicators.

Ben Scríobh:

Leis an parsáil Argóint #2 Bheadh ​​níos oiriúnaí a:

A. Bench top steam sterilization equipment can only [go héifeachtach] sterilize clean or new equipment.
B. Clean equipment is that equipment which is free of protein deposit, bioburden, or any other biological or chemical material which will impede delivery of thermal energy or presents a potential health risk in and of itself.
C. Used tattoo and piercing equipment has been contaminated with human blood on other potential infectious materials in such a fashion that has been clinically proven to harbor culturable pathogens. A study in the U.K. demonstrated that after processing including a tunnel washer and several hydro sonic processes, a tattoo tube still retained enough active biological material to successfully culture it. Repeated cleansing processes failed to remove this material.

Sterilization equipment is tested to see if it performs according to it’s designed parameters by regular spore testing. These tests do not indicate its ability to perform beyond its designed parameters.

Wes Scríobh:

Argóint # 3

A. Bench top autoclaves cannot sterilize the inside of tubes, hollow spaces, porosity ná cuasa.

B. Tattoo tubes have hollow spaces inside of tubes.

Conclúid: Tattoo tubes cannot be sterilized using bench top autoclaves.

Rebuttal do Argóint # 3

Steam penetrates and reaches every available area providing massive heat transfer, cuasa lena n-áirítear, inside tubes and everywhere air reaches. Because the entire object is raised to the sterilizing temperature everything is sterile. Premise A is false and the conclusion is not proved. Is é an chonclúid bréagach.

Ben Scríobh:

Léiríonn an achoimre míthuiscint ar an Meicnic de gaile próiseas steiriliú. Gaile úsáidtear mar mhodh a sheachadadh teirmeach fuinnimh na dromchlaí a sterilized. Is é pressurization na gaile is gá chun é a bhaint amach teocht ag a bhféadfaidh sé go héifeachtach aimridiú na dromchlaí. I bpróiseas dí-éighníomhach aer, an pressurization an tseomra dhíláithrítear éighníomhach an t-aer. Áit ar bith a Is féidir an t-aer a bheith gafa (a fissure, hinge, nó feadán), Is é an t-aer féin brú ar shlí nach gaile penetrate go hiontaofa sé. Triomaigh Ní aer steiriliú go héifeachtach dromchlaí ag an teocht chéanna go gaile a dhéanann.

An t-ábhar nach bhfuil ach ar oscailt le haghaidh díospóireachta: tá sé ina ábhar na fírinne cliniciúla agus, i go leor cásanna, rialachán dlíthiúil. An [13060] MDA rangú barr binse trealamh steiriliú gaile go soiléir go bhfuil cineál N trealamh (dí-áitiú aer éighníomhach) nach bhfuil oiriúnach le haghaidh ionstraimí aimridithe le insí, feadáin nó lumens, scoilteanna, fissures, lochtanna dromchla eile, dromchlaí porous (lena n-áirítear uige), nó earraí pacáistithe. An t-eisiamh Clúdaíonn aice gach ítim a úsáidtear i tatúnna agus tolladh coirp réimse.

Wes Scríobh:

Argóint # 4

A. Disposing of used equipment is safer than sterilizing used equipment.

B. Tattoo and piercing should use the safest method.

Conclúid: Tattoo and Piercing should dispose of all used equipment.

Rebuttal do Argóint # 4

Má tá nua agus a úsáidtear earra dá steiriúla go bhfuil siad araon, sábháilte agus. Being ”nua” níl aon impleacht go bhfuil sé níos sábháilte. Premise A is false and does not support the conclusion that disposable tools are safer.

Ben Scríobh:

Using the equipment and methods commonly used in the reprocessing of tattooing agus piercing ionstraimí, a used item will never be sterile again. A passive displacement steam sterilization process won’t sterilize the surface and the protein and biological payload cannot be removed with an adequate degree of certainty. A brief examination of the approach used by the medical community will reveal much: even with multi million dollar sterilization facilities and a large highly educated staff, most instruments that come in contact with human blood are disposed of. Those instruments that are reprocessed are of extremely high cost or are those that do not come into contact with broken skin. Tá do fhrisnéis bunaithe ar an bréagach go FÉIDIR ionstraimí a cuí a athphróiseáil ar bhealach éifeachtach ó thaobh costais le iontaofa torthaí. Tá an coincheap a arís agus arís eile agus go seasta defeated i trialacha cliniciúla agus taighde leighis thar na tríocha bliain anuas. Tá sé seo, brónach a rá, léiriú is gnách ar an contemporaneousness leighis eolas i measc an phobail ealaíne comhlacht: Rinneadh athbhreithniú ar na caighdeáin sin sa 60′s Ceaptar go ginearálta a bheith eolas reatha nuair a, ar ndóigh, siad nach bhfuil. Caighdeáin steiriliú agus cleachtais Tá athbhreithniú déanta go maith ó bhí steiriliú gaile éighníomhach dí-choitianta san ospidéal suímh, go háirithe le blianta beaga anuas le feasacht a mhéadú ar iompraíochtaí phataigineacha anta agus prión agus seasmhachta.

Wes Scríobh:

Go raibh maith agat as a thabhairt dom an deis chun freagra a thabhairt ar na hagóidí.

Ben Scríobh:

And thank you for giving me the opportunity to address these common misconceptions about sterilization and basic safety precautions.

Conclúidí

1. Steiriliú Ba chóir a bheith níos sábháilte do nua, éillithe, míreanna i gceart glanadh ná nithe athphróiseáil.
2. Má tá athphróiseáil fostaithe, sé Ba chóir a dhéanamh de réir fianaise eolaíochta atá bunaithe ar mholtaí.

TUILLEADH EOLAIS

• CDC Treoirlíne maidir Díghalrú agus steiriliú in Áiseanna Cúram Sláinte, 2008
• Tá stair achomair ar steiriliú
• Ag obair le autoclave Statim

Tá suim agam ar an eolas faoi do chuid smaointe ar an ábhar seo. Le do thoil comment thíos chun leanúint leis an díospóireacht.