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Piercing Guns

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Conventions

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

General Standard Procedures

1. The Premises

Proper design and layout of the premises has an important role to play in the prevention of cross-contamination and/or infection.  The premises must be clean and be capable of being kept clean relatively easily.  All internal parts of the structure of the premises i.e.: walls, floors, doors, windows, ceilings, woodwork etc., should be maintained in a clean condition and kept in good repair.  To facilitate this, floor & wall coverings should be smooth, durable, impervious and readily cleanable.
It is preferable that the treatment area be separate to the waiting area.   Not only is this important from a hygiene point of view, but also from one of privacy.

1.1 The Treatment Area

  • This area should have a bench or chair for treating customers that is covered in a washable, non-absorbent surface that is readily cleanable.
  • Provision should be made for maintaining adequate and suitable ventilation throughout the premises.
  • Provision should be made for maintaining suitable and sufficient lighting in every part of the premises, whether natural or artificial.
  • A separate area with a sink with instantaneous running hot & cold water should be provided for the cleaning of the premises and the equipment. 
  • A wash hand basin, with a constant supply of running hot & cold water, should be provided in the treatment area, solely for the washing of hands.  Adjacent to the wash hand basin, there needs to be a constant supply of liquid soap and a suitable means of hand drying such as disposable paper towels, or cabinet roller towels.
  • All sinks and wash hand basins throughout, should be properly connected to the drainage system, it is also preferable for the taps to be foot or elbow operated, especially in the treatment area.
  • Smoking is prohibited in both the treatment area and the waiting area.  Notices relating to this are required under the Public Health (Tobacco) Acts 2002 and 2004.
  • No animals shall be allowed into the treatment area, with the exception of guide dogs.
  • There should be a first aid kit containing a sufficient supply of suitable bandages, dressings, antiseptic cream etc. kept on the premises.  It is strongly recommended that the operator be trained in basic first aid.
  • Proper waste storage should be provided in the treatment area, a sharps box and preferably a lidded container for general waste.
  • The treatment area should be set up such that the ‘clean’ and ‘dirty’ areas are clearly defined or zoned.  Section the treatment area for storage of clean and sterilized equipment, the working/piercing area and the area for dirty equipment prior to cleaning/sterilization.  None of these areas should overlap. 
  • Sufficient sanitary accommodation should be provided.  The sanitary accommodation shall be clean at all times, the floor, walls and ceiling surfaces being rendered readily cleanable.  There should be wash hand basin(s) adjacent to the sanitary accommodation with hot and cold running water, liquid soap and suitable method of hand drying such as disposable paper towels, cabinet roller towels or electric hand dryers.

 

2. Materials Used.

2.1 Needles
Best practice for all types of skin piercing is to use pre-sterilised single use needles.  Under no circumstances should any item with needles attached marked by its manufacturer as single use, be cleaned and sterilised for re-use on another client.
There are two types of needles used in tattooing. The best practice is to use single-use disposable needles or needle and tube sets. Soldering of needle points onto needle bars in tattooing is no longer advocated as best practice. As stated above, best practice for all types of skin is to use pre-sterilised single use needles. However, where tattooists continue to make their own needles by soldering needle points onto bars, lead free solders should be used for this purpose. Needles soldered onto needle bars should be cleaned before sterilisation.  Excess solder should be removed and it is useful to place the soldered needle and needle bar in the ultra sonic cleaner to further remove excess solder and any other residues, prior to sterilisation.  Re-usable must always be thoroughly cleaned and sterilised before re-use on another client.
Sterile needles should be handled with sterile forceps and whilst wearing single-use

Carefully visually check all needles prior to use. Any needles that exhibit any abnormalities such as hooks, slivers etc shall be discarded immediately on discovery and not used on any person.

Under no circumstances should any item marked as single-use by its manufacturer be cleaned and sterilised for re-use on another client.
Other instruments that have penetrated the skin or are contaminated with blood must be properly cleaned and sterilised before further use.

2.2 Jewellery

All jewellery, which may come into contact with broken skin or mucous membranes, must be sterilised prior to use.

The type of metal or plastic used to make jewellery is very important. A distinction should be made between the jewellery used during the healing process and that worn after the wound has completely healed.

Jewellery Used During the Healing Process
Jewellery used during the healing period following setting of a piercing should conform to the following:

  • If homogenous materials are used, the nickel concentration cannot exceed 0.05%; “homogenous” refers to a material that has an identical physical and/or chemical composition in every part- in other words is of a uniform nature.
  • If heterogeneous materials are used, they must not contain any traces of nickel. “Heterogeneous” refers to a metal that is composed of materials that are not of the same type or of a uniform nature.

The material to be worn during the healing process must furthermore be hypoallergenic and unaffected by body fluids and tissues, salt or fresh water, oils and greases, soap and hair products. It must be possible to high-gloss polish the metals used and they must be resistant to rusting.  The surface must not be porous in order to resist the growth of micro-organisms. The proper length and diameter of the jewellery must be determined depending on the individual client’s needs and applied.

Surgical stainless steel is often used as jewellery in the initial stages after application (for as long as the wound has not healed). In almost all cases however, surgical steel does not conform to the above condition concerning nickel content.

 

The following metals are commonly used:

  • titanium (grade: ASTM Ti6A14V ELIF-136-98)
  • surgical steel (grade: ASTM 316 LVMF-138-97)
  • niobium and tantalum
  • yellow gold (14 and 18 carat, solid)
  • white gold (14 and 18 carat, solid)
  • platinum
  • PTFE (Polytetrafluoroethylene)
  • tygon (S-54-HL)
It should be noted that 18 carat gold may not be suitable as it is considered to be too soft, leading to it being too easily scratched and able to harbour infection
Jewellery Worn After the Wound Has Completely Healed

Jewellery worn following the healing period should conform to the following:

  • Jewellery that has not been electroplated must not release more than 0,5 µg/cm2 of nickel per week.
  • Jewellery that has not been electroplated must not release more than 0,5 µg/cm2 of nickel per week for a period of at least two years of normal wear.
  •  

Besides the above-mentioned materials, jewellery containing the following material may be worn after the wound has recovered completely:

  • non-toxic hardwood
  • non-toxic plastics
  • Perspex
  • Plexiglas

Please note:

Silver, sterling silver and gold-plated jewellery do not meet the above requirements and therefore should not be used for healed or unhealed piercing.
Piercers must keep up to date as best practice relating to jewellery is constantly changing.

 

2.3 Inks and Pigments

Inert organic compounds are used to produce tattooing inks.  They must be of a medium particle size.  Always use a reliable supplier.  Tattooists need to ask their supplier for evidence that the pigments are free from heavy metals and other hazardous substances.  Remember that all pigments are manufactured for a use other than tattooing.  If dilution is carried out on your premises, only use potable water from the public water supply and ethyl alcohol.

Pigment that has been used on one client must not be used on another client.  If using bulk liquid pigment, only dispense enough in to sterile disposable caps for each client.  Any pigment left over after a client shall be disposed of along with the disposable container.  If non-disposable containers are used, they must be capable of being cleaned and sterilised between each client.

Always store pigments appropriately, protecting them from contamination.  If storing bulk containers of pigments, these must have spouts that cannot be removed for refilling (squeeze bottles). These bottles should be sealed with caps so that no dirt or micro-organisms contaminate the contents. At this stage it is uncertain how long these bottles can be stored. Maintain small supplies of squeeze bottles if possible.

 

1. Before Treatment

  • The work area should be prepared in such a way so as to avoid having to leave the client in the middle of a procedure to get something which may be needed.
  • Ensure that the work area is clean and tidy.
  • Ensure sharpsbin in easy reach.
  • Ensure that all items needed are within easy reach and that any items not required are removed from the immediate area.
  • Place a container labelled ‘Dirty Instruments For Sterilising’ in the work area for the collection of instruments.
  • Prepare a new skin-cleaning spray daily according to the manufacturer’s instructions.
  • Spray bottles should be covered in a good-grade plastic bag to protect the bottle from contamination. The bag should be changed between each client.
  • Prepare the chair /couch/arm rest as appropriate to the site of the procedure.
  • Hands must be washed thoroughly prior to the procedure and disposable gloves worn.
  • Packages containing sterile needles should be checked for damage and date.

WRITTEN SIGNED CONSENT must be obtained from the client PRIOR to procedure.
VERBAL AND WRITTEN INSTRUCTIONS ON THE AFTER CARE of the tattoo and/or piercing site must be given.

1.1   Anaesthetics

The administration oflocal anaesthetic creams, gels, spays etc., is not recommended. Piercers should not administer local anaesthetic injections or prescription-only topical creams.  Ethyl chloride should not be used under any circumstances, as there is an appreciable risk due to flammability, cryogenic properties (frostbite) and respiratory sensitisation.
Antibiotic or antiseptic creams should not be used.

2. After Treatment

  • The operator should discard all needles into a sharps container immediately following use.
  •  Dispose of all single-use items (spatula, pigment caps and tray, used tissues, wipes and paper towels etc.) into the domestic waste bag. If bloodstained place in the yellow waste bag.
  • Change paper towel on couch/chair - wipe down if soiled and at the end of each session.
  • Change bags around spray bottle and tattoo machine
  • Place all dirty instruments into the container marked ‘Dirty Instruments’ for removal to cleaning area.
  • Pre-clean any re-usable instruments in the sink with hot soapy water. Re-usable instruments should then be placed into the ultrasonic cleaner and sterilised in the autoclave prior to re-use.
  • Wash and dry all equipment before autoclaving.
  • Clean containers used for collecting dirty instruments with GPD and hot water. Store dry. 
  • Remove gloves and disposable aprons and discard in the clinical waste bag. .
  • Wash, rinse and dry hands thoroughly.

 

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