Dacă nu este curat nu pot fi sterilizate

În 2003 I wrote a summary interpretation for my colleagues who were questioning a website recommending an instrument processing method that seemed unusual and unsafe. Particularitate a acestei metode era că tatuaj şi piercing echipamente ar fi autoclavă [căldură umedă] processed înainte de a curăţare.

Rezumat

After researching the Unimax System and exploring the supposed benefits, I propose a safer solution for tattooists [şi piercers] would be to use pre-sterilized disposable [echipamente, cum ar fi] tuburi si bare-AC 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 [cu această metodă].

Defect principal în sistemul de:

[Sistemul sugerează că] equipment only needs rinsing or wiping off with disinfectant cloth before heat is applied.

  • Clătire dilueaza dar nu elimina proteinele, 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.
  • O dată spălat sau şters, equipment that is allowed to dry and have heat applied at the end of the work day compounds the difficulty of removing [coagulat] proteine.

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

Proteine (endotoxine rezistentă la căldură) sunt fierte on and into scratched surfaces on tools, în special în tuburi.

Reziduuri de proteine şi cerneală în interiorul vârful tatuaj

Reziduuri de proteine şi cerneală în interiorul tubului de tatuaj

Reziduuri de proteine şi cerneală în interiorul tatuaj grip

Pentru piercing, acelaşi lucru se aplică, though new jewelry and equipment all can be sterilized in a type B vacuum or type S positive pressure flush process autoclave, aşa cum este descris în documentul ataşat.

Opinia mea personală:

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

Rebuttal and discusson

Scris de Wes Woods:

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

Ben corcodel, colegul meu de Piercing experienţă Wrote:

Vă sunt cu siguranţă gratuit nu sunt de acord cu aceste concluzii. Totuşi, 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, cercetători independent, 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:

Sediul şi concluziile sunt analizat mai jos urmat de o rebuttal.

Argumentul # 1

A. Distrugere de endotoxină, inactivation or removal is the criteria for demonstrating the efficacy (încredere) unui proces de sterilizare.

B. Endotoxine nu sunt eliminate folosind gravitate deplasare sterilizatoare.

Concluzia: Sterilizatoare de deplasare gravitatea nu sunt fiabile.

Respingerea Argument # 1

Inactivarea 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. Argumentul # 1, Premisa A este fals, therefore the conclusion is not proved by the argument.

Ben a scris:

Această interpretare a argumentului este, cel mai bun, an unintentional misrepresentation. În nici un punct este Endotoxină 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. Mai important, 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 se referă la acest proces de evaluare]

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: eliminarea de endotoxine [înainte de sterilizare] is a functional component of those parameters.

Problema de primă importanţă, totuşi, 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, cum ar fi [FDA sau] MDA în Marea Britanie.

Wes Wrote:

Argumentul # 2

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

B.Clean sau echipamente noi: endotoxină gratuit.

C. Used tattoo and piercing equipment contain endotoxins.

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

Respingerea Argument # 2

Clean means relatively free of gross contamination that would interfere with the sterilizing process. Este o chestiune de grad, not an absolute. Clean does not mean the absence of endotoxins. Premisa A este fals, 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 a scris:

Parsarea de Argument #2 ar mai fi în mod corespunzător:

A. Bench top steam sterilization equipment can only [în mod eficient] 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:

Argumentul # 3

A. Bench top autoclaves cannot sterilize the inside of tubes, hollow spaces, porozitate nici carii.

B. Tattoo tubes have hollow spaces inside of tubes.

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

Rebuttal la Argument # 3

Steam penetrates and reaches every available area providing massive heat transfer, inclusiv carii, 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. Concluzia este fals.

Ben a scris:

Acest rezumat reprezintă o neînţelegere a mecanicii de abur proces de sterilizare. Abur este folosit ca o metodă de livrare termice energie pentru a suprafetelor pentru a fi sterilizate. Presurizare de abur este necesară pentru a ajunge la o temperatură la care se poate în mod eficient se sterilizează suprafeţele. Într-un proces de deplasare de aer pasiv, The presurizare a camerei de pasiv deplasează aerul. Oriunde care aer poate fi prins (o fisura, balama, sau tub), aer în sine este sub presiune astfel că abur nu fiabil pătrunde l. Uscat aer steriliza în mod eficient suprafetele la aceeași temperatură care abur are.

Această problemă nu este pur şi simplu deschise pentru dezbatere: este o chestiune de fapt clinice şi, în multe cazuri, reglementarea juridică. The [En13060] MDA categorisirea de banc de top echipamente de sterilizare de abur în mod clar statele care N echipamente de tip (pasiv aer deplasare) nu este potrivit pentru sterilizarea instrumentelor cu balamale, tuburi sau lumeni, fisuri, fisuri, alte defecte de suprafata, suprafeţe poroase (inclusiv tifon), sau ambalate mărfuri. Această excludere acoperă aproape fiecare element utilizat în tatuare si body piercing câmp.

Wes Wrote:

Argumentul # 4

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

B. Tattoo and piercing should use the safest method.

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

Rebuttal la Argument # 4

Dacă un nou şi un element utilizate sunt sterile sunt atât ca în condiţii de siguranţă. Being ”noi” nu implică faptul că este mai sigur. Premise A is false and does not support the conclusion that disposable tools are safer.

Ben a scris:

Using the equipment and methods commonly used in the reprocessing of Tatuajele si piercing instrumente, 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. Respingerea dumneavoastră se bazează pe premisa falsă că instrumentele pot fi în mod corespunzător fie reprelucrat într-o manieră cu incredere rezultate. Această noţiune a fost în mod repetat şi în mod constant învins în studiile clinice şi de cercetare medicală în ultimele trei decenii. Acest lucru este, trist să spun, o reprezentare tipic de contemporaneousness medicale cunoştinţe în comunitatea de artă organism: standarde care au fost revizuite în 60′s sunt în general considerate a fi cunoştinţelor atunci când, desigur, ei nu-i ’ t. Sterilizare standarde şi practici au fost complet revizuite de sterilizare de abur pasiv de deplasare a fost comune în spital Setări, în special în ultimii ani, cu creşterea gradului de conştientizare a retrovirală şi prion patogene comportamente si rezistenta.

Wes Wrote:

Multumesc pentru că mi-posibilitatea de a răspunde la aceste obiecţii.

Ben a scris:

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

Concluzii

  1. Sterilizare fi mai sigur pentru noi, necontaminate, curăţate în mod corespunzător articolele decât recalculat elemente.
  2. Dacă reprocesare este angajat, l se face conform recomandărilor ştiinţifice bazate pe dovezi.

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