Dalam 2003 SAYA wrote a summary interpretation for my colleagues who were questioning a website recommending an instrument processing method that seemed unusual and unsafe. Keganjilan dari metode ini adalah bahwa tato dan tindik peralatan akan autoklaf [lembab panas] processed sebelum pembersihan.

Ringkasan

After researching the Unimax System and exploring the supposed benefits, I propose a safer solution for tattooists [dan piercers] would be to use pre-sterilized disposable [peralatan, seperti] tabung dan jarum-Bar pre-sterilized, 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 [dengan metode ini].

Cacat utama dalam sistem:

[Sistem Anda menunjukkan bahwa] equipment only needs rinsing or wiping off with disinfectant cloth before heat is applied.

• Membilas mencairkan tetapi tidak menghapus protein, 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.
• Sekali dibilas atau dihapus, equipment that is allowed to dry and have heat applied at the end of the work day compounds the difficulty of removing [digumpalkan] protein.

Common bench top autoclaves are only capable of sterilizing clean or new equipment that does not have any sort of cavity, porositas, hollow spaces or tubes. Pasif, 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.

Protein (tahan panas endotoxins) dimasak on and into scratched surfaces on tools, terutama tabung.

Residu protein dan tinta dalam tato tip

Residu protein dan tinta di dalam tabung tato

Residu protein dan tinta di dalam cengkeraman tato

Untuk menusuk, hal yang sama berlaku, though new jewelry and equipment all can be sterilized in a type B vacuum or type S positive pressure flush process autoclave, seperti yang dijelaskan dalam dokumen yang dilampirkan.

Pendapat pribadi saya:

[SAYA] 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 Wrote:

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, rekan saya dari Piercing pengalaman Wrote:

Anda akan pasti bebas tidak setuju dengan kesimpulan ini. Namun, 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, independen peneliti, and health regulatory authorities. Specific examples of the inadequacies of the provided counter arguments will be provided in a point for point format.

Wes Wrote:

Lokal dan kesimpulan yang diuraikan di bawah ini diikuti oleh bantahan.

Argumen # 1

A. Endotoksin kehancuran, inactivation or removal is the criteria for demonstrating the efficacy (keandalan) proses sterilisasi.

B. Endotoxins tidak dihapus menggunakan gravitasi perpindahan sterilizers.

Kesimpulan: Gravitasi perpindahan sterilizers tidak dapat diandalkan.

Bantahan argumen # 1

Inaktivasi spora, 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. Argumen # 1, Premis A adalah False, therefore the conclusion is not proved by the argument.

Ibnu Majjah wrote:

Penafsiran ini argumen adalah, terbaik, an unintentional misrepresentation. Pada titik tidak ada Endotoksin 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. Lebih penting lagi, 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 mencakup proses evaluasi ini]

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: penghapusan endotoxins [sebelum sterilisasi] is a functional component of those parameters.

Masalah kepentingan utama, Namun, 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, seperti [FDA atau] MDA di Inggris.

Wes Wrote:

Argumen # 2

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

B.Clean atau peralatan baru berarti endotoksin gratis.

C. Used tattoo and piercing equipment contain endotoxins.

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

Bantahan argumen # 2

Clean means relatively free of gross contamination that would interfere with the sterilizing process. Ini adalah masalah gelar, not an absolute. Clean does not mean the absence of endotoxins. Premis A palsu, 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.

Ibnu Majjah wrote:

Parsing argumen #2 lebih tepat akan:

A. Bench top steam sterilization equipment can only [secara efektif] 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 Wrote:

Argumen # 3

A. Bench top autoclaves cannot sterilize the inside of tubes, hollow spaces, porositas atau rongga.

B. Tattoo tubes have hollow spaces inside of tubes.

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

Bantahan untuk argumen # 3

Steam penetrates and reaches every available area providing massive heat transfer, termasuk rongga, 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. Kesimpulannya palsu.

Ibnu Majjah Wrote:

Ringkasan ini mewakili kesalahpahaman mekanika Uap proses sterilisasi. Uap digunakan sebagai metode untuk menghantarkan termal energi untuk permukaan yang dapat disterilkan. Sebagai'ketegangan Uap adalah diperlukan untuk mencapai suhu yang dapat secara efektif mensterilkan permukaan. Dalam proses perpindahan pasif udara, The sebagai'ketegangan ruang pasif CH3COOH udara. Mana saja yang udara mungkin terjebak (celah, engsel, atau tabung), udara itu sendiri bertekanan sedemikian rupa bahwa uap tidak dapat diandalkan menembus itu. Kering Udara tidak efektif mensterilkan permukaan pada temperatur yang sama yang Uap tidak.

Hal ini tidak hanya terbuka untuk perdebatan: Hal ini sebenarnya klinis dan, dalam banyak kasus, Peraturan legal. Para [En13060] MDA kategorisasi atas bangku Uap sterilisasi peralatan dengan jelas menyatakan bahwa jenis peralatan N (perpindahan pasif udara) ini tidak cocok untuk sterilisasi instrumen dengan engsel, tabung atau lumens, retak, celah, cacat permukaan lainnya, permukaan berpori (termasuk kasa), atau barang-barang yang dikemas. Pengecualian ini mencakup dekat setiap item yang digunakan dalam tato dan body piercing field.

Wes Wrote:

Argumen # 4

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

B. Tattoo and piercing should use the safest method.

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

Bantahan untuk argumen # 4

Jika baru dan item yang digunakan keduanya steril mereka sama-sama sebagai aman. Being ”Baru” tidak menyiratkan bahwa itu lebih aman. Premise A is false and does not support the conclusion that disposable tools are safer.

Ibnu Majjah Wrote:

Using the equipment and methods commonly used in the reprocessing of tato dan tindik instrumen, 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. Bantahan Anda didasarkan pada premis palsu yang instrumen dapat tepat batangan tersebut secara efektif dengan dapat diandalkan hasil. Gagasan ini telah berulang kali dan konsisten dikalahkan di uji klinis dan penelitian medis selama tiga dekade terakhir. Ini adalah, sedih untuk mengatakan, khas representasi dari contemporaneousness medis pengetahuan di komunitas seni tubuh: standar yang direvisi di 60′s umumnya dianggap sebagai pengetahuan saat ini ketika, Tentu saja, mereka aren ’ t. Sterilisasi standar dan praktek-praktek telah benar-benar direvisi karena pasif perpindahan sterilisasi adalah umum di rumah sakit pengaturan, terutama tahun terakhir dengan meningkatkan kesadaran retroviral dan prion patogen perilaku dan ketahanan.

Wes Wrote:

Terima kasih untuk memberikan saya kesempatan untuk menjawab keberatan tersebut.

Ibnu Majjah Wrote:

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

Kesimpulan

1. Sterilisasi harus lebih aman untuk baru, tidak tercemar, benar dibersihkan item dari reprocessed item.
2. Jika pengolahan yang digunakan, itu harus dilakukan sesuai dengan rekomendasi berbasis bukti ilmiah.

INFORMASI LEBIH LANJUT

• CDC pedoman untuk desinfeksi dan sterilisasi di fasilitas kesehatan, 2008
• Sejarah singkat sterilisasi
• Bekerja dengan autoklaf Statim

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