Getting A New Piercing

Sterilization is the process of killing all microorganisms including bacteria, fungi, viruses, and bacterial spores. The needle, jewelry, and all instruments that touch the piercing or the jewelry must be sterilized. Improper sterilization or lack thereof can result in the spread of infectious bacteria and viruses. Boiling is not a suitable method of sterilization.

The most complete and reliable method of sterilization is the steam or chemical process autoclave. The steam autoclave uses pressurized steam; the chemical autoclave often uses Ethylene oxide. Autoclave sterilization is used by medical professionals and meets federal standards of sterilization.

Steam autoclaves are used by piercers more frequently than chemical autoclaves because of the hazards associated with Ethylene oxide.

While OSHA Standards (December 6, 1991; 29 CFR 1910.1030) recognizes dry heat sterilizers, they are not the best option for maintainence of some of the equipment used for piercing.

Pressure cookers may also be used for sterilization but with many disadvantages. Sterilizing items in a pressure cooker is more time consuming and requires a separate heating element. Pressure cookers are not as reliable as autoclaves in maintaining temperature and pressure and do not display time, temperature or pressure (PSI). If a pressure cooker is used, items should be processed for at least 30 minutes at 15-20 pounds pressure (270 degrees F; 132.2 degrees C). Use of a pass/fail indicator inside every sterilization package is strongly suggested. Pressure cookers will not dry the sterilized items and as long as a sterilization bag is wet it is susceptible to contamination.

Prior to sterilization, instruments should be cleaned with an ultrasonic cleaner. The ultrasonic uses vibration to remove any solid debris; it does not sterilize. The ultrasonic cleaner is usually filled with a hospital-level disinfectant solution (see 3.4g) which is replaced daily. Jewelry should not be placed in the ultrasonic cleaner with tools or other jewelry because it will be scratched.

Autoclaves as well as dry heat sterilizers should be tested regularly by an independent laboratory. Monthly or weekly test kits are available from most sterilization supply companies and through some tattoo supply companies. These kits contain two bacteria spore samples, one of which is cycled in the autoclave and the other used as a control. Spore tests can also be used with each load.

Another type of autoclave test are pass/fail indicators placed on the inside of each autoclave package to indicate that the inside of the package has been penetrated. These indicators react to time, temperature and steam pressure and not simply to heat.

Instruments to be sterilized are placed in sterilization bags which are then sealed with indicator tape. Both the bag and the tape are marked with indicator strips which change color to indicate that the item has been processed or exposed to heat. Indicator strips on autoclave bags and tape are not indicative of proper sterilization.

Piercing needles usually arrive from the manufacturer or supplier pre-sterilized in sealed autoclave bags. Many piercers take the added precaution of resterilizing needles or buying in bulk and sterilizing the needles themselves so that there is no question of how the sterilized needle has been handled.

Surgical steel forceps and other tools made specifically for piercing such as needle pushers and insertion tapers are manufactured to be autoclave-safe.

All surgical stainless steel, titanium, niobium, and platinum jewelry can be safely sterilized. Gold jewelry will be discolored by certain chemicals (for example, iodine) and may become discolored in the autoclave when placed in autoclave bags with heat indicators.

Hospital-level disinfectants, such as Madacide and Wavicide, destroy many microorganisms but do not destroy bacterial spores. Disinfectants do not replace autoclave sterilization.

These disinfectants are used disinfecting hard surfaces (ie. trays, table, chair) before and after each piercing procedure. Product usage instructions vary, and some may not be suitable for all surfaces or applications. Some disinfectants are very irritating, toxic, and require special disposal. This factor should be taken into account when using disinfectants for jewelry presoak.

Centers for Disease Control and Prevention - Hospital Infections Program "Sterilization or Disinfection of Patient-Care Equipment: General Principles" http://www.cdc.gov/ncidod/diseases/hip/sterilgp.htm "MadaCide-1: Technical Presentation 08/01/97" manual MADA Medical, 60 Commerce Road, Carlstadt, New Jersey 07072 1-800-526-6370, (201) 460-0454

OSHA "Occupational Exposure To Bloodborne Pathogens Standards" http://www.osha-slc.gov/OshStd_data/1910.1030.html