如果不是清洁不进行消毒
在 2003 我 wrote a summary interpretation for my colleagues who were questioning a website recommending an instrument processing method that seemed unusual and unsafe. 这种方法的特点是，纹身和穿孔设备将高压灭菌器 [清热化湿] 处理 之前， 清洗.
摘要
After researching the Unimax System and exploring the supposed benefits, I propose a safer solution for tattooists [和刺] would be to use pre-sterilized disposable [设备, 如] 管和饰物的针酒吧, 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 [使用这种方法].
在系统中的主要缺陷:
[您的系统表明，] equipment only needs rinsing or wiping off with disinfectant cloth before heat is applied.
- 冲洗稀释但不移除蛋白质, 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.
- 一次冲洗或抹去, equipment that is allowed to dry and have heat applied at the end of the work day compounds the difficulty of removing [凝结] 蛋白质.
Common bench top autoclaves are only capable of sterilizing clean or new equipment that does not have any sort of cavity, 孔隙率, hollow spaces or tubes. 被动, 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.
蛋白质 (耐热内毒素) 要煮熟 on and into scratched surfaces on tools, 特别是管.
蛋白质和油墨残留内纹身提示
纹身管内的蛋白和油墨残留物
纹身手柄内的蛋白质和油墨残留物
冲孔, 这同样适用, though new jewelry and equipment all can be sterilized in a type B vacuum or type S positive pressure flush process autoclave, 所附加的文档中所述.
我个人的看法:
[我] 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 森林写道：:
I disagree with the conclusions that tattoo and piercing should dispose of used contaminated equipment instead of re-processing them for re-use.
Ben 卡鲁思, 我的同事从冲孔经验写道：:
您可以肯定自由同意这些结论. 然而, 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, 独立研究人员, and health regulatory authorities. Specific examples of the inadequacies of the provided counter arguments will be provided in a point for point format.
Wes 写道：:
处所和结论分析下面跟反驳.
参数 # 1
一. 内毒素销毁, inactivation or removal is the criteria for demonstrating the efficacy (可靠性) 灭菌过程.
乙. 内毒素不会删除使用重力位移灭菌器.
结论: 重力位移灭菌器不可靠.
反驳论点 # 1
灭活的孢子, 嗜热脂肪, 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. 参数 # 1, A 的前提是 False, therefore the conclusion is not proved by the argument.
Ben 写道：:
这种解释的参数是, 在最佳, an unintentional misrepresentation. 在没有点是 内毒素 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. 更重要的是, 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 涵盖这一评价过程]
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: 内毒素去除 [事先绝育] is a functional component of those parameters.
最重要的问题, 然而, 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, 如 [FDA 或] 在英国的 MDA.
Wes 写道：:
参数 # 2
一. Bench top autoclaves can only sterilize clean or new equipment.
B.Clean 或新设备是指内毒素免费.
彗星. Used tattoo and piercing equipment contain endotoxins.
结论: Used tattoo and piercing equipment cannot be sterilized using a bench-top sterilizer.
反驳论点 # 2
Clean means relatively free of gross contamination that would interfere with the sterilizing process. 它是一个程度问题, not an absolute. Clean does not mean the absence of endotoxins. A 的前提是虚假, 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 写道：:
参数的分析 #2 将更多适当地是吗:
一. Bench top steam sterilization equipment can only [有效] sterilize clean or new equipment.
乙. Clean equipment is that equipment which is free of protein deposit, 输液, or any other biological or chemical material which will impede delivery of thermal energy or presents a potential health risk in and of itself.
彗星. 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 写道：:
参数 # 3
一. Bench top autoclaves cannot sterilize the inside of tubes, hollow spaces, 孔隙度也腔.
乙. Tattoo tubes have hollow spaces inside of tubes.
结论: Tattoo tubes cannot be sterilized using bench top autoclaves.
反驳论点 # 3
Steam penetrates and reaches every available area providing massive heat transfer, 包括腔, 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. 得出的结论是虚假.
Ben 写道：:
此摘要表示对蒸汽的力学的误解 灭菌过程. 蒸汽用作方法，提供热 能源对表面进行消毒. 蒸汽增压是 它能够达到的它可以有效地温度的必要条件 对曲面进行消毒. 在被动空气置换过程中, 在 分庭的加压被动地取代空气. 任何地方， 空气可能被困 (窝沟封闭, 铰链, 或管), 空气本身是 这样蒸汽没有可靠地穿透它加压. 干 空气不有效消毒表面在同一温度， 蒸汽没有.
只是这件事不是公开辩论: 它是临床事实 和, 在许多情况下, 法律规制. 该 [En13060] MDA 的工作台上的分类 蒸汽杀菌设备明确指出，键入 N 设备 (被动空气位移) 不适合消毒仪器 与铰链, 管或流明, 裂缝, 裂缝, 其他表面缺陷, 多孔表面 (包括纱布), 或包装的货物. 这种排斥 涵盖了附近的纹身和身体穿孔字段中使用的每个项目.
Wes 写道：:
参数 # 4
一. Disposing of used equipment is safer than sterilizing used equipment.
乙. Tattoo and piercing should use the safest method.
结论: Tattoo and Piercing should dispose of all used equipment.
反驳论点 # 4
如果一个新的和用过的物品都不育它们都作为安全. Being ”新增功能” 并不意味着它是更安全. Premise A is false and does not support the conclusion that disposable tools are safer.
Ben 写道：:
Using the equipment and methods commonly used in the reprocessing of 纹身和穿孔文书, 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. 你的反驳意见基于虚假的前提下，文书可以是 适当地重新与可靠成本效益的方式进行处理 结果. 这一概念已被多次和一贯地击败中 过去三年来的医学研究和临床试验. 这是, 不幸的是，, contemporaneousness 医疗的典型代表 人体艺术社区知识: 年中修订的标准 60′s 一般被认为是当前知识时, 答案是肯定的, 他们 没有 ’ t. 灭菌的标准和做法有了彻底的修订 因为被动位移蒸汽灭菌是共同在医院 设置, 特别是在近年来日益认识到的 反转录病毒和朊病毒致病性的行为及耐力.
Wes 写道：:
谢谢你让我有机会回答这些反对意见.
Ben 写道：:
And thank you for giving me the opportunity to address these common misconceptions about sterilization and basic safety precautions.
结论
- 消毒 应 更安全的新, 无公害, 正确清洁项目比后处理的项.
- 如果后处理受雇, 它 应 可根据基于证据科学建议进行.
