Ef það er ekki hreint að það er ekki hægt að sótthreinsuð
Í 2003 Ég wrote a summary interpretation for my colleagues who were questioning a website recommending an instrument processing method that seemed unusual and unsafe. The gæði af þessari aðferð var að tattoo og göt búnað væri autoclave [rakur hita] processed áður en til hreinsun.
Samantekt
After researching the Unimax System and exploring the supposed benefits, I propose a safer solution for tattooists [og piercers] would be to use pre-sterilized disposable [búnaður, svo sem] slöngur og fyrirfram sótthreinsuð nál-bars, 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 [með þessari aðferð].
Helstu galli í kerfinu:
[Vélin þín bendir til þess að] equipment only needs rinsing or wiping off with disinfectant cloth before heat is applied.
- Skolun dilutes en ekki fjarlægja prótein, 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.
- Þegar skola eða þurrka, equipment that is allowed to dry and have heat applied at the end of the work day compounds the difficulty of removing [coagulated] prótein.
Common bench top autoclaves are only capable of sterilizing clean or new equipment that does not have any sort of cavity, grop, hollow spaces or tubes. A óbeinum, 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.
Prótein (hitaþolnum endotoxins) eru soðin on and into scratched surfaces on tools, einkum slöngur.
Prótein og blek leifar inni húðflúr ábending
Prótein og blek leifar inni húðflúr rör
Prótein og blek leifar inni grip húðflúr
Fyrir göt, sama gildir, though new jewelry and equipment all can be sterilized in a type B vacuum or type S positive pressure flush process autoclave, eins og lýst er í meðfylgjandi skjali.
Mín skoðun:
[Ég] 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 Skrifaði:
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, samstarfsmaður minn af reynslu Piercing Skrifaði:
Þú ert vissulega frjálst að vera ósammála með þessar niðurstöður. Hins vegar, 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, sjálfstæðir vísindamenn, and health regulatory authorities. Specific examples of the inadequacies of the provided counter arguments will be provided in a point for point format.
Wes Skrifaði:
Forsendur og niðurstöður flokka hér á eftir vefengingar.
Argument # 1
A. Endotoxin eyðileggingu, inactivation or removal is the criteria for demonstrating the efficacy (áreiðanleika) í ófrjósemisaðgerð ferli.
B. Endotoxins eru ekki fjarri því að nota þyngdarafl sæþunga sterilizers.
Ályktun: Gravity tilfærslu sterilizers eru ekki áreiðanleg.
Vefenging Argument # 1
The óvirkjun af Spore, 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. Argument # 1, Forsenda A er rangt, therefore the conclusion is not proved by the argument.
Ben skrifaði:
Þessi túlkun á rök er, í besta falli, an unintentional misrepresentation. Hvergi er 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. Meira um vert, 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 nær þetta mat ferli]
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: afnám endotoxins [fyrir dauðhreinsun] is a functional component of those parameters.
Útgáfu meginmáli, þó, 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, svo sem [FDA eða] MDA í Bretlandi.
Wes Skrifaði:
Argument # 2
A. Bench top autoclaves can only sterilize clean or new equipment.
B.Clean eða ný tæki þýðir endotoxin frítt.
C. Used tattoo and piercing equipment contain endotoxins.
Ályktun: Used tattoo and piercing equipment cannot be sterilized using a bench-top sterilizer.
Vefenging Argument # 2
Clean means relatively free of gross contamination that would interfere with the sterilizing process. Það er spurning um hversu, not an absolute. Clean does not mean the absence of endotoxins. Forsenda A er ósönn, 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 skrifaði:
The þáttun rök #2 væri meira viðeigandi að:
A. Bench top steam sterilization equipment can only [í raun] 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 Skrifaði:
Argument # 3
A. Bench top autoclaves cannot sterilize the inside of tubes, hollow spaces, grop né holum.
B. Tattoo tubes have hollow spaces inside of tubes.
Ályktun: Tattoo tubes cannot be sterilized using bench top autoclaves.
Vefenging að rök # 3
Steam penetrates and reaches every available area providing massive heat transfer, þ.mt holum, 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. Niðurstaðan er falskur.
Ben skrifaði:
Þetta yfirlit sýnir að misskilningur af aflfræði af a gufu ófrjósemisaðgerð ferli. Gufa er notuð sem aðferð til að skila varma orku til að yfirborð verði sótthreinsuð. Pressurization af gufu er nauðsynlegt til þess að ná hita þar sem það getur í raun sótthreinsa yfirborð. Í aðgerðalaus loft tilfærslu ferli, á pressurization úr herberginu displaces passively loftið. Hvar sem loftið getur verið föst (a sprunga, löm, eða neðanjarðarlest), loftið sjálft er þrýstingi þannig að gufa ekki áreiðanlegur komast það. Þurrkaðu loft er ekki í raun að sótthreinsa yfirborð á sama hitastig sem gufa er.
Þetta mál er einfaldlega ekki opinn til umræðu: það er spurning um klíníska staðreynd og, í mörgum tilvikum, lagaleg reglugerð. The [13060] MDA flokkun efst bekkur gufu ófrjósemisaðgerð búnaður skýrt þessi tegund N búnað (aðgerðalaus loft tilfærslu) er ekki hentugur fyrir dauðhreinsun hljóðfæri með lömum, rör eða lúmen, sprungur, sprungur, annarra galla yfirborði, porous yfirborð (þ.mt grisja), eða pakkavörur. Þessi útilokun nær nálægt hverjum lið notuð í tattooing og líkama Piercing sviði.
Wes Skrifaði:
Argument # 4
A. Disposing of used equipment is safer than sterilizing used equipment.
B. Tattoo and piercing should use the safest method.
Ályktun: Tattoo and Piercing should dispose of all used equipment.
Vefenging að rök # 4
Ef ný og notuð atriði eru bæði dauðhreinsuð þeir eru báðir eins örugg. Being ”ný” felur ekki í sér að það er öruggara. Premise A is false and does not support the conclusion that disposable tools are safer.
Ben skrifaði:
Using the equipment and methods commonly used in the reprocessing of húðflúr og göt hljóðfæri, 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. Hrakning þitt er byggt á fölskum forsendum að skjöl geta verið viðeigandi reprocessed á hagkvæman hátt með áreiðanlegum Niðurstöður. Þessi hugmynd hefur verið ítrekað og stöðugt ósigur í klínískar rannsóknir og læknisfræðilegar rannsóknir á síðustu þremur áratugum. Þetta er, sorglegt að segja, dæmigerð framsetning á contemporaneousness á lækningatækjum þekking á list líkamanum samfélag: stöðlum sem voru endurskoðuð 60′s eru almennt talin vera núverandi þekkingu þegar, auðvitað, þeir eru ekki. Ófrjósemisaðgerð staðla og venjur hafa verið rækilega endurskoðað þar aðgerðalaus tilfærslu gufu ófrjósemisaðgerð og algengt var á sjúkrahúsi Stillingar, sérstaklega á undanförnum árum með vaxandi meðvitund um Antiretroviral og Prion sjúkdómsvaldandi hegðun og þrek.
Wes Skrifaði:
Takk fyrir að gefa mér tækifæri til að svara þessum mótmælum.
Ben skrifaði:
And thank you for giving me the opportunity to address these common misconceptions about sterilization and basic safety precautions.
Ályktanir
- Ófrjósemisaðgerð ætti vera öruggari fyrir nýtt, ómengað, almennilega hreinsað atriði en reprocessed atriði.
- Ef endurvinnslu er starfandi, það ætti að gera, samkvæmt niðurstöðum vísindalegra tillögur.
NÁNARI UPPLÝSINGAR
- CDC Leiðbeiningar fyrir sótthreinsun og dauðhreinsun í heilbrigðisstofnanir, 2008
- Stutt saga um ófrjósemisaðgerð
- Vinna með Statim autoclave
