0 Si no está limpio no puede ser esterilizado - brnskll.com

Si no está limpio no puede ser esterilizado

En 2003 ME wrote a summary interpretation for my colleagues who were questioning a website recommending an instrument processing method that seemed unusual and unsafe. La peculiaridad de este método era ese tatuaje y piercing equipo sería autoclave [calor húmedo] procesado antes de limpieza.

El resumen

After researching the Unimax System and exploring the supposed benefits, I propose a safer solution for tattooists [y piercers] would be to use pre-sterilized disposable [equipo, tal como] tubos y barras de la aguja preesterilizadas, 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 [con este método].

La principal falla en el sistema:

[El sistema sugiere] equipment only needs rinsing or wiping off with disinfectant cloth before heat is applied.

  • Enjuague diluye pero no elimina las proteínas, 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.
  • Una vez limpiado o limpiar, equipment that is allowed to dry and have heat applied at the end of the work day compounds the difficulty of removing [coagulada] proteínas.

Common bench top autoclaves are only capable of sterilizing clean or new equipment that does not have any sort of cavity, porosidad, hollow spaces or tubes. Un pasivo, escriba N desplazamiento por gravedad esterilizador como se muestra y describe en el sistema Unimax no es físicamente capaz de limpiar las superficies internas de los tubos del tatuaje fiable.

Proteínas (Endotoxinas resistente al calor) se cocinan on and into scratched surfaces on tools, particularmente los tubos.

Residuos de proteínas y la tinta dentro de la punta del tatuaje
Residuos de proteínas y la tinta dentro del tubo del tatuaje
Residuos de proteínas y la tinta dentro del tatuaje agarre

Para la perforación, lo mismo se aplica, though new jewelry and equipment all can be sterilized in a type B vacuum or type S positive pressure flush process autoclave, como se describe en el documento adjunto.

Mi opinión personal:

[ME] 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 escribió:

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, mi colega de Piercing experiencia escribió:

Eres libre, sin duda, de acuerdo con estas conclusiones. Sin embargo, 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, investigadores independientes, and health regulatory authorities. Specific examples of the inadequacies of the provided counter arguments will be provided in a point for point format.

Wes escribió:

Las premisas y las conclusiones se analizan a continuación, seguido de una refutación.

Argumento # 1

A. Destrucción de endotoxina, inactivation or removal is the criteria for demonstrating the efficacy (confiabilidad) de un proceso de esterilización.

B. Endotoxinas no se quitan con esterilizadores de desplazamiento de gravedad.

Conclusión: Esterilizadores de desplazamiento de gravedad no son confiables.

Argumento de refutación # 1

La inactivación de la espora, 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. Argumento # 1, Premisa A es falso, therefore the conclusion is not proved by the argument.

Ben escribió:

Esta interpretación del argumento es, en el mejor, an unintentional misrepresentation. En ningún momento es Endotoxina 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. Lo más importante, 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 cubre este proceso de evaluación]

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: la eliminación de endotoxinas [antes de la esterilización] is a functional component of those parameters.

La cuestión primordial, sin embargo, 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, tales como la [FDA o la] MDA en el Reino Unido.

Wes escribió:

Argumento # 2

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

B.Clean o equipo nuevo significa libre de endotoxinas.

C. Used tattoo and piercing equipment contain endotoxins.

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

Argumento de refutación # 2

Clean means relatively free of gross contamination that would interfere with the sterilizing process. Es una cuestión de grado, not an absolute. Clean does not mean the absence of endotoxins. Premisa A es falsa, 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 escribió:

El análisis de argumento #2 más adecuada sería:

A. Bench top steam sterilization equipment can only [efectivamente] 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 escribió:

Argumento # 3

A. Bench top autoclaves cannot sterilize the inside of tubes, hollow spaces, porosidad ni cavidades.

B. Tattoo tubes have hollow spaces inside of tubes.

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

Refutación al argumento # 3

Steam penetrates and reaches every available area providing massive heat transfer, incluyendo las cavidades, 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. La conclusión es falsa.

Ben escribió:

Este resumen representa un malentendido de la mecánica de un vapor proceso de esterilización. Vapor se utiliza como un método de entrega termal energía a las superficies a ser esterilizados. Presurización del vapor es es necesario para que alcance una temperatura a la que puede con eficacia esterilizar las superficies. En un proceso de desplazamiento de aire pasiva, la presurización de la cámara desplaza pasivamente el aire. Dondequiera que el aire puede quedar atrapado (una fisura, bisagra, o tubo), el aire sí es a presión de tal manera que vapor no fiable penetrar. Seco aire no esteriliza eficazmente las superficies a la misma temperatura que vapor hace.

Esta cuestión simplemente no está abierta para el debate: se trata de hecho de la clínica y, en muchos casos, regulación legal. El [EN13060] Categorización de MDA de mesa equipo de esterilización de vapor claramente Estados que tipo equipo de N (desplazamiento de aire pasiva) no es adecuado para la esterilización de instrumentos con bisagras, tubos o lúmenes, grietas, fisuras, otros defectos en la superficie, superficies porosas (incluyendo la gasa), o mercancías embaladas. Esta exclusión cubre cerca de cada elemento utilizado en los tatuajes y piercing campo del cuerpo.

Wes escribió:

Argumento # 4

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

B. Tattoo and piercing should use the safest method.

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

Refutación al argumento # 4

Si un nuevo y un elemento utilizado son estériles son tanto como seguro. Being “Nuevo” no implica que es más seguro. Premise A is false and does not support the conclusion that disposable tools are safer.

Ben escribió:

Using the equipment and methods commonly used in the reprocessing of tatuajes y piercing instrumentos, 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. Su refutación se basa en la falsa premisa de que pueden ser instrumentos procesar adecuadamente de manera rentable con confiable resultados. Esta noción ha sido repetida y sistemáticamente derrotada en ensayos clínicos e investigación médica en las últimas tres décadas. Es, triste decirlo, una representación típica de la contemporaneidad de médicos en la comunidad de arte de cuerpo: las normas que fueron revisadas en el 60’s are generally thought to be current knowledge when, Claro, ellos aren ’ t. Prácticas y estándares de esterilización han sido minuciosamente revisadas esterilización por vapor desplazamiento pasivo era común en hospital Configuración, particularmente en los últimos años con mayor conciencia de retroviral y comportamientos patógeno prión y resistencia.

Wes escribió:

Gracias por darme la oportunidad de responder a estas objeciones.

Ben escribió:

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

Conclusiones

  1. Esterilización debe más segura para los nuevos, sin contaminar, limpiar correctamente elementos de nuevos artículos.
  2. Si se emplea el reprocesamiento, se debe según las recomendaciones científicas basadas en la evidencia.

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