Brian W Skellie – Sharing ideas
Why use a non-sterile dental bib when there are safer sterile options that are proven moisture barriers? Options and discussion.
A surgeon who first advocated sterilized gloves. The first paper on sterile gloves in 1897: WZ von Manteuffel
Brian Skellie teaches sterilization skills for the professional body piercer and tattooist in Milan at the 7th APTPI congress
STATIM is not “flash sterilization” and the term should no longer be used in reference to sterilization cycles for unwrapped items.
For brevity, I suggest that you use all sterile disposable single use items, however if you are to reprocess used instruments: Classes Publications
In the current 2013 edition of the APP Procedure Manual, I helped correct the previously confusing references to Statim autoclaves.
The current 2013 version of the guidelines refer to the Statim and the acceptable use of unwrapped sterilization methods.
Sterilization Methods:
Benchtop Sterilization
- Steam under pressure (saturated steam/steam autoclave): 220-270 kpa pressure at 132° Centigrade (270° Fahrenheit) for 3-40 minutes depending on cycle.
- Steam autoclave process types
- Steam flush-pressure pulse (type S):
“Another design in steam sterilization is a steam flush-pressure pulsing process, which removes air rapidly by repeatedly alternating a steam flush and a pressure pulse above atmospheric pressure. Air is rapidly removed from the load as with the prevacuum sterilizer, but air leaks do not affect this process because the steam in the sterilizing chamber is always above atmospheric pressure. Typical sterilization temperatures and times are 132°C to 135°C with 3 to 4 minutes exposure time for porous loads and instruments.” The Statim is an example of a type S steam flush pressure pulse autoclave, which is acceptable for sterilization.
Aseptic Field
The actual procedure surface is referred to as an “aseptic field,” and is a sterilized surface that becomes exposed to air contact only at the beginning of the piercing procedure. The aseptic field used by most piercers is the sterile inside surface of a freshly opened large autoclave or sterile glove package, Statim cassette, rigid sterilization container, or sterilized tray. Once the package is opened, sterile tools, needles, jewelry, and disposables can be dropped onto the inside surface for use. The exterior of sterilized packages such as those containing the jewelry should not touch the aseptic field; the contents should be carefully dispensed onto it.
DISPOSABLE SUPPLIES
To minimize the risk of cross-contamination and to ensure that piercing room procedures are as clean as possible, many components of the tray setup must be disposable. Unless supplies are purchased presterilized* or will be sterilized in an autoclave immediately prior to the procedure, all disposables must be individually packaged in autoclave bags, sterilized, and remain intact in their pouches stored in enclosed, nonporous drawers or containers until use. Disposable materials that must be sterilized include: marking implements, piercing needles, corks or synthetic stoppers, elastic bands, swabs, and gauze.
* This includes only FDA-cleared items that are commercially sterilized according to accepted medical standards. The supplier must make documentation of appropriate sterilization available.
Trade in your old sterilizer for credit towards a new STATIM cassette autoclave!
Here is a glimpse of a few piercings I performed during an exhibition for colleagues in New England. I enjoy sharing ideas and techniques with my peers. Let me know what you think.
My goal is an atraumatic aseptic technique: Primum non nocere
All of these piercings were performed without clamps using the STATIM 2000 autoclave, sterilized single use equipment, sterile nitrile gloves, and the titanium jewelry was anodized with the Reactive Metals Micro anodizer.
Other than making people shiny, my job is to help my fellow piercers and tattoo artists make their work easier, cleaner and safer
