What defines a clean tattoo parlor

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BadWolf
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What defines a clean tattoo parlor

Post by BadWolf » Wed Apr 19, 2006 2:30 pm

Autoclave? What is that, and why should you care if I have one??


An autoclave is a devise that uses steam under pressure to kill any living organism and it's spores that may be present. The pressure is important as it:
A. allows the temperature to surpass the boiling point to a temperature known to kill bacteria spores...and
B. it also forces the steam into tiny nooks and crannies in the instruments being sterilized.

For that reason, no other form of sterilizer is suitable for tattooing or piercing, which would be feasable in a studio setting. Toaster ovens and pressure cookers are not to be used. Anyone with the knowledge to use one of those effectively WOULD OPT NOT TO USE ONE.
The effectiveness of an autoclave is easily validated by regularly spore testing it...where spore samples are sent to a lab, after being run through the autoclave, and if they are able to reproduce, the sterilizer failed. If they cannot reproduce, it is working properly.
Just having an autoclave isn't proof of ANYTHING. It should be spore tested regularly (at least monthly) and records of sterilization should be kept. Sterile packages should be marked with a lot number, and a log book which keeps track of when that lot was processed...by whom...etc.
Ask to see it!
Also, whether or not instruments remain sterile is dependant upon EVENT. So, the instruments need to be stored in an appropriate manner. This is also why PRE-STERILIZED DISPOSABLE NEEDLES AND TUBES SHOULD NOT BE RELIED UPON. We do not know every event that took place from the time they were alledgedly sterilized, shipped, etc. until they were opened...therefore we can NOT validate that they are still sterile, and they should NOT be relied upon.



Barriers AND germacidals??? Why both??

From the time you sit down in the chair (or lie on the table, etc) EVERYTHING that you or the tattooist touches, including said chair or table, MUST BE AUTOCLAVABLE OR DISPOSABLE.
Since the machines, spray bottles, countertop, lamp, power supply knob, etc. cannot be thrown away or autoclaved, it MUST NOT BE TOUCHED. So, the only way to prevent that is by putting a barrier between it and your grubby hands, as well as the client's bloody body part. They make barrier film, which is a poly 4X6 inch sheet with a tacky adhesive for some surfaces like knobs and lamps. Poly bags work well on spray bottles, machines, clip cords. Poly/paper bibs work well on counters, chairs, etc.
Hell, even butcher paper with the plastic coating on one side and masking tape is better than nothing!
Even though the barrier was used, the surface must STILL be cleaned with a high level germacidal solution, once the contaminated barrier is removed and discarded, and a new barrier used for each client. And the barrier should be removed carefully, so as to not contaminate anything during or after the removal.

WHY must it still be cleaned?
Because if something is disposable, we don't have to worry about it coming in contact with the next client. It simply get's thrown away.

If it is autoclavable, I can VALIDATE...scientifically...that it is clean and sterile, by using indicators, pass/fail strips, and regular spore testing.

But even if I contaminate a spray bottle with my bloody glove, then clean it with a high level germacidal, I cannot VALIDATE, SCIENTIFICALLY that the germacide worked as it should have....nor can I scientifically validate that a barrier worked...unless I have a lab come and swab the bottle, do a culture, and wait a week until I take someone else in.

When the two are used together, it works this way
:
1. The barrier controls or prevents contamination from getting on the surface.

Now, in the off chance something does get by,

2. The germacide will LIKELY kill it.

And in a worst case scenario, if the organism survives both 1 and 2, (and remember...we cannot scientifically validate, one way or another) then,

3. The next barrier you put on that bottle will likely CONTAIN anything left on it, and keep it from getting from the surface to your glove to the client.

So, on their own, neither cleaners nor barriers are acceptable for non-disposable or non-autoclavable surfaces.
But, combined, they work to slant the odds GREATLY in your favor...they make the risk negligable...almost non-existant.



Am I in the right place???

By this time, everyone doing tattoos should be educated enough to be in compliance with modern aseptic practices. If they aren't, they never will be...and unfortunately with the influx of untrained scratchers opening studios, VERY FEW studios meet minimal requirements.
Anyone doing tattoos should have some inner force driving them to keep up on these things, and will spare no expense, and go to whatever means to do so. If not, they aren't tattoo artists.

Here is what I look for:
In a studio with one artist, I want to see 5 rooms.

1. The waiting room.
-This room can get dirty after a busy day. The staff should make an attempt to keep it clean and organized as much as possible.

2. A seperate procedure room.
-Must be seperated from the rest of the studio by at LEAST a 4 foot wall. Preferably, it will be an entirely seperate room. In no other way can an artist assure you of cleanliness, as he will have no control over the environment of the work area. This room should be VERY CLEAN...no clutter...no stuff sitting on the work area that isn't absolutely necessary for the tattoo being done. Everything else should be in cabinets or shelves away from the work area, and sterile instruments should be kept in a locked cabinet in suitable containers with lids to keep them from being tampered with. No carpet...floor should be tile or some scrubable material. Walls cleanable, and everything should be set up to be easily cleaned after each and every client. Anything touched in this room from the time you sit down, until you leave, should be autoclavable or disposable. Barriers should be used on everything else. Barriers must be changed and surfaces should be cleaned with a high level disinfectant between clients.

3. The restroom.
-Should be maintained properly.

4. The cleaning room (where contaminated instruments are addressed.)
-This room is NOT to be used for any other purpose. It MUST contain a sink. The restroom CANNOT be used for this purpose, either!! If their autoclave is in this room, or if this room is not seperate from the rest of the studio, RUN...don't walk...RUN to the exit!!...and don't touch ANYTHING on your way out!


5. A seperate sterilization room with spore tested autoclave. -Nothing else should be in this room aside from bulk sterile instruments stored properly in suitable containers. Contaminated instruments should be wrapped and placed on autoclave trays in the cleaning room (4) and taken to the autoclave room (5) where they are placed DIRECTLY into the already opened autoclave without coming into contact with ANYTHING ELSE. Contaminated gloves should be removed and disposed of, THEN the autoclave door closed and the timer set. Nothing that is contaminated should EVER enter this room in any other way. NOTHING in this room may be touched with contaminated gloves or other contaminated items.
THIS ROOM SHOULD BE SPOTLESS!
It is not difficult to provide for such a room. There is no excuse for not having one. A medium sized closet can be converted with minimal expense, since the only thing in it will be a sterilizer. My studio had an offset area that is 5 feet by 7 feet. We closed it off and put a door and ventilation in it. The small room is easier to keep clean, and converting the space cost a hundred bucks or so if you are handy with power tools.
If they won't take the time to do this, RUN TO THE EXIT!
DO NOT BE FOOLED! An indicator strip or a "pass/fail" indicator is NOT a spore test. The studio should have doccumentation of AT LEAST monthly spore tests done by an outside source.

If more than one artist is working at a time, each should have a seperate procedure room.

These rooms cannot be combined in any way and still be safe. This is why it is nearly impossible to work from your home safely. It would take the entirety of most people's houses. If the studio isn't set up in this fashion, ask when they intend to start meeting standards. If you work in a place that doesn't meet standards, it is easily accomplished. You have no excuse aside from laziness or lack of knowing...and now ya know.
If the space you are renting will not allow for this, MOVE.

Then I look for the certificates from health courses they have completed. At a MINIMUM, they should have a red cross certification in 'preventing cross contamination'.
Only after they have met this criteria, will I bother to leaf through a portfolio. Up until then, (or if they can't meet those requirements) their portfolio is absolutely meaningless. If they are filthy, the best art work in the world isn't going to get me in their dirty chair at ANY price.

If the artist meets those requirements, and is doing the type of work I want, I will pay top dollar. It is worth it.
Last edited by BadWolf on Wed Apr 19, 2006 2:44 pm, edited 1 time in total.

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Post by caringiscreepy » Thu Jul 19, 2007 11:04 am

I am not sure if it is required and I don't think you mentioned it but what about being certified by the Red Cross? I live in PA so I think the laws are different all around but I think the tattoo shop I go to is the only one around that is certified by the RC or maybe they were the first. I don't remember. I am not good with details.

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Post by BadWolf » Sun Jul 22, 2007 3:25 pm

There is no statewide law concerning that, but in the area I am in, it is required that all tattooists complete a red cross course in preventing cross contamination..which is basically a blood borne pathogen course.
Not doing so is punishable by a fine and possible loss of the license from the health department.

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Post by lotusvoid » Sat Sep 15, 2007 12:16 am

good article badwolf. I was curious about a few things though... it maked sence to seperate the prep area and the autoclave area, but necessitating the transfer of contaminated materials from room to room, bagged or not seems wierd to me. notice i am not contradicting, just picking your brain. It would make more sense to me to have one room with a divider between the autoclave and the prep/ultrasonic area. I also would not feel comfortable storing my sterile supplies in the same room, aside from strips, bags, pore strips and gloves

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Post by BadWolf » Sat Sep 15, 2007 4:25 am

If the supplies are sterile, why shouldn't they be in the same room? They are KNOWN to be sterile, and cannot contaminate the area....so why wouldn't that be feasable?
Furthermore, when you transport contaminated instruments through a room to a sterilizer, if those instrument do not come into contact with anything, what is the risk? If I go from the cleaning room to a sterilization room and touch nothing in between, what have I contaminated?
Sterilization bags should not be in the sterilization room because the WHOLE POINT is to not process contaminated equippment in the area that sterile equippment is being brought out into. The equippment is processed in the cleaning room. Then taken directly to the already open autoclave, put in, contaminated gloves removed and discarded without touching anything in the sterilization room, autoclave door closed, and timer set.
Ultrasonic cleaning and manual cleaning both create mist of fine spatter from contaminated tools. So unless the barrier/divider is an actual wall (which makes it two rooms), it wouldn't really be much good.

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PRE-STERILIZED DISPOSABLE NEEDLES AND TUBES

Post by TJ_Tats » Sun Sep 16, 2007 6:24 pm

BadWolf wrote:
Also, whether or not instruments remain sterile is dependant upon EVENT. So, the instruments need to be stored in an appropriate manner. This is also why PRE-STERILIZED DISPOSABLE NEEDLES AND TUBES SHOULD NOT BE RELIED UPON. We do not know every event that took place from the time they were alledgedly sterilized, shipped, etc. until they were opened...therefore we can NOT validate that they are still sterile, and they should NOT be relied upon.
I agree and disagree at the same time with this.

I agree that it is the Tattoo Artist responsibility to ensure his/her customers safety. Therefore checking out his/her suppliers first and ensuring they are reputable and selling a good product. This is what I agree with.

I disagree that disposable needles and tubes are a bad thing SHOULD NOT BE RELIED UPON.

The particular company I get my Pre-Sterilized Needles and Tubes from post their sterilization procedures on their home page or will mail them to you upon request, and use bubble packaging for the needles on a nearly card stock backing.

For these packages to be compromised with out me knowing would be nearly impossible as long as I give the items a simple inspection . The tubes I buy are in the standard paper/plastic sterile bags that hospitals and other medical communities use. Again, these would be hard to damage or tear and me not notice.

The ETO sterilization techniques used by my supplier and used by most needle manufactures and piercing needle manufacturers are also used by the medical community to pre-sterilize all of their injection needles, blood drawing needles and any other disposable product used by the medical industry.

The Following Statement is taken from the MD&DI website Medical Device & Diagnostic Industry Magazines website

"Among the sterilization technologies currently available to the medical device industry, 100% ethylene oxide (EtO) gas remains one of the most popular. Validated EtO processes can be run in sterilizers ranging from BIER vessels of a few cubic feet to industrial-sized vessels exceeding 4500 cu ft."

Now occasionally I get a bad needle and need to throw it away and get a new one. I inspect my needles with an eye loop both before and after I place them in the tube for damage. Damaged ones get thrown out.

Tattooing does not cut open the skin and if properly done tattooing shouldn't puncture threw the skin entirely either. Though it does happen it should not be a regular occurrence.

Spores and air born bacteria are always present unless you are in a positive vacuum pressured room with hospital grade HEPA air inlet filters such as many surgical or clean rooms.

I have yet to find a tattoo studio that is set up like this.

However, nearly any tattoo friendly doctor will tell you if you clean the area to be tattooed with the proper antibacterial/germicidal cleaners then clean and treat with a anti bacterial ointment such as Bacitracin or Neosporin and cover to keep airborne bacteria and spores from settling in and your customer has a standard healthy immune system you should be fine.

In addition since the pre-sterilization techniques used for piercing and tattoo needles are the same as those used in the medical community, at least in the case of my vendor I feel I can use them with confidence a simple inspection to ensure the items were run threw the sterilizer and the marker dots have changed color and the packaging is not damaged keeps my conscious clear. By the way, ETO does not affect the test papers in the same manner Autoclaving does. Consult the manufacturer if you are in doubt at all. They will almost always replace if there are questions or explain if you are unsure. Don’t be afraid to ask questions.

Companies who claim to sell sterilized needles have huge legal liability should someone contract an infection from their needles. Considering the company I use is selling millions of needles per year and supply most of the other resellers of sterilized needles I doubt they would take the risk of not following the procedure. I think for the few cents extra per needle they would just sell them bubble packed ready for sterilization before taking on that kind of legal responsibility by claiming pre-sterilized.

If a customer gets an infection and you have followed sound cleanliness techniques and used pre-sterilized needles and tubes it is more likely that the customer did not care for IE Clean the tattoo properly as instructed "Provided the artist is competent and gave them aftercare instructions" or the Ink has Become contaminated or your sprayer or the spray solution is growing bacteria before a pre-sterilized needle causes that infection.

If you are going to use pre-sterilized needles you must inspect for the so called EVENT. Package isn't damaged, needles are not damaged everything looks and is as it should be.

Be smart not paranoid about your tattoo. I agree that cleanliness is by far very important we can't get caught up in the hype created by those competing with others. If the hospitals and doctors offices across the country are using pre-sterilized needles for all types of applications that’s good enough for me.

The hate for the unclean scratch tattoo artist has created many overly elaborate unnecessary ideas about how to keep your customers safe.

Before using a pre-sterilized needle

Check out your supplier
Inspect the package and the needles
Follow barrier and cleanliness procedures that are set up by the medical community not your local tattoo ya hoo.
You can take cross contamination courses and there is a lot of good ligature on the subject also. I suggest you read up if you haven’t already.

Study, learn and know your business.

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Post by BadWolf » Mon Sep 17, 2007 12:17 pm

So you would rather trust a 3rd party than take the few minutes to toss them in an autoclave for the maximum time at the lowest temperature? Explain to me why you are willing to accept the word of a third party instead of removing any shred of doubt by taking a few minutes to do it yourself. Explain the advantage to that method, PLEASE.
You keep saying CONSULT THE MANUFACTURER IF YOU HAVE ANY DOUBTS.
THAT IS ABSOLUTELY RETARDED!!!
Why not just sterilize them and HAVE NO DOUBTS TO BEGIN WITH??
http://www.inkinctattoo.com/tubes.jpg

Post the results from the last test done on your manufacturer's sterilizer equippment to prove it is in working order.

Try this:
Hang a sign in your waiting room that says,

"We trust someone who we have never met to sterilize our equippment instead of taking the time to do it ourselves. They told us it is sterile, and that's good enough for us! We feel the few minutes it would take to do the sterilization on our own, which would remove any doubts, isn't worth the hastle, and we are comfortable trusting your health and well being to someone we have never met.
Thank you!"

See how your clients react to that.

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Post by BadWolf » Tue Sep 18, 2007 11:37 am

Just about any modern autoclave will allow you to run a 250degree cycle for 30 minutes. That temperature will not harm the packaging, and then you have NO REASON to wonder about the manufacturer. You have no reason to call them...as though they'd tell you if their equippment was shoddy!
Make the effort or go find something safer to do.
Period.
The topic of this post is: "What defines a clean tattoo parlor"
Laziness and trusting someone you never met to do the most important job there is, is NOT representative of what I would consider a clean tattoo parlor.

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RE What defines a clean tattoo parlor

Post by TJ_Tats » Sat Sep 22, 2007 11:36 am

BadWolf wrote:Just about any modern autoclave will allow you to run a 250degree cycle for 30 minutes. That temperature will not harm the packaging, and then you have NO REASON to wonder about the manufacturer. You have no reason to call them...as though they'd tell you if their equippment was shoddy!
Make the effort or go find something safer to do.
Period.
The topic of this post is: "What defines a clean tattoo parlor"
Laziness and trusting someone you never met to do the most important job there is, is NOT representative of what I would consider a clean tattoo parlor.
You either didn't read my post or you yourself or you don’t understand it. Yes, I would trust a company that does this constantly and that’s all they do before I would trust you telling me you did it properly. I have been piercing and tattooing with pre-sterilized needles for the last five years of my working in the industry with zero known problems.

I do understand the post and I was simply trying to say that on the topic of sterilization there’s only one listed method of being clean. You can have a clean studio with out owning a sterilizer. I know you want everyone to invest a couple of grand in a sterilizer to show you how clean they are. Well to bad wolf. I have one and use it for all my piercing jewelry, and tools. I buy pre-sterilized needles though.

Another issue is you obviously don’t understand the ETO sterilization, this is the standard and its not steam based so your comment on lowest temperature and shortest period of time is unfounded as you don’t understand ETO and you call me lazy for using pre-sterilized equipment, but you didn’t take the time to research what I was saying before you responded. This simply points out how big that chip on your shoulder is. If you had taken the time to do some research on those things you didn’t understand, you would had seen that these units can be as large as 4500 cubic ft and successfully sterilize the items in that area.

My insurance company accepts both methods also. From the customers prospective I would definitely trust the disposable equipment before I trusted you telling me you did it properly. My customers are comfortable and many have commented on how they like the fact that everything I use is pre-sterilized and disposable.

Furthermore I spoke to the health inspector for the area and she prefers to see pre-sterilized disposable equipment. Though they will license a studio in either case she said she is more comfortable seeing disposable equipment. Why do you think that is?

If people with 6 to 12 years or more of education in the medical field trusts these companies to sterilize their disposable equipment then I will take their word over yours any day. I don’t know why you think a bunch of tattoo artists know more then the entire medical community?

I also do have a sign on my cards that states: I only use Sterilized, Disposable Needles and Tubes.

Last but not least I have reviewed some of your post and see how you rip anyone that doesn’t do things your way. FYI your way isn’t the only PROPER way of doing things as stated above. There are usually many ways of doing things properly.

I will not post my suppliers, that’s my business and posting my suppliers names here is not good business.

By the way don't insult me again; I didn’t appreciate the retarded comment. You will get it back every time.

I recommend you do some searching on line and study up on the following topics.

Why manufacturers would be foolish to make a claim and not back it:
Legal liability Product Manufacturer claims
http://en.wikipedia.org/wiki/Product_liability

ETO Sterilization
http://www.devicelink.com/mddi/archive/98/12/006.html

Just a couple to get you started.

I will no longer debate this issue we can agree to disagree.

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Post by BadWolf » Sat Sep 22, 2007 1:57 pm

What does Wikipedia say about this? What research can I do to explain this? Post me a link so I can start educating myself! Does wikipedia say anything about the color BLUE??:lol: :lol:


Simple as that!
The company I bought those from ASSURE me they are SUPER SWELL guys and are very thorough.
Trust in them all you like. I prefer to NOT take chances with MY clients.
The companies who manufacture instruments for the tattooing industry are NOT the same people who manufacture instruments for the medical community and are NOT regulated by the same agencies, or made to keep the same standards. And even with all of the regulation the medical industry has, they still make mistakes, they still slip up, and people get sick and die because of it. What generally causes that? Too many hands in the sauce, not watching what one another is doing, and trusting that everyone did what they were supposed to.
You go ahead and trust that guy you never met to do your sterilization instead of taking a few minutes to toss them in your autoclave. I, however, don't deal in trust. I deal in CERTAINTY.
And if your clients and local authorities are comfy with their level of false security, then more power to 'em!
Last edited by BadWolf on Sat Sep 22, 2007 5:33 pm, edited 1 time in total.

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Post by BadWolf » Sat Sep 22, 2007 4:09 pm

Another issue is you obviously don’t understand the ETO sterilization, this is the standard and its not steam based so your comment on lowest temperature and shortest period of time is unfounded as you don’t understand ETO and you call me lazy for using pre-sterilized equipment, but you didn’t take the time to research what I was saying before you responded.
Sorry, but you got some egg on your face. I fully understand gas sterilization. What I said (in other words) is that if you take the "alledgedly" pre-sterilized needles once they arrive at your place of business, and toss them in a steam sterilizer at the lowest temp for the longest cycle, it will sterilize the instrument, and you don't even have to re-wrap them. By using the lowest temp, you can use the packaging they are already in. It takes hardly any effort at all, and then YOU CAN BE CERTAIN. You do not have to rely on TRUSTING that guy YOU NEVER MET.
I hope this makes it easier to comprehend.
Furthermore I spoke to the health inspector for the area and she prefers to see pre-sterilized disposable equipment. Though they will license a studio in either case she said she is more comfortable seeing disposable equipment. Why do you think that is?
I am not certain why that is, but I imagine it has to do with her being confused about who the manufacturer is, and what guidelines they must adhere to. She may be under the false impression (as you would seem to be) that the people who do the sterilization for FDA, ADA, and AMA approved products are the same ones sterilizing YOUR stuff, and are held to the same standards. That DOES seem to be a real misunderstanding. But if you post her name and number, I will be more than happy to call and ask her. No one ever accused beurocrats of being geniuses, or even competent, but I will be happy to help you find the answer to this burning question.
I figure the LEAST we could do is give her the opportunity to participate in this thread, and enlighten everyone. Perhaps she can answer this: If those tubes I got from that trusty tattoo supply warehouse are actually sterile, then why O why are the indicators all the wrong color? I mean with all the high standards you claim these folks adhere to, all the legalities they have to face, and everything else the great and wise oracle known as "wikipedia" says, (not to mention you and your clients undying trust, faith and devotion) I know there must be a damn good and valid answer out there SOMEWHERE, and your friend seems so on top of things, I would like to think she could help. Maybe we're all just COLORBLIND! Eh?
I located the New Milford Burrough office, at (570) 465-3238. Can I call her at that number, or is her office elsewhere?

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Post by BadWolf » Tue Jan 08, 2008 11:31 am

blackmamba77 wrote:
How would any legit artist know that a needle YOU brought was sterile??
Why not just go to a tattooist that:
A. Uses new needles.
B. Autoclaves them, as well as all re-usable instruments in a spore tested autoclave.
C. Documents it.
i just scared that their needle was not sterile.im just wanna make sure of myself if i bring my own ofcourse its sterile.
If a company who manufactures needles and alledgedly sterilizes them is unable to convince me that they have done the job properly because of the lack of documentation, how in the WORLD do you suppose you are gonna convince me that anything YOU dragged in with you is sterile????

I have a sterilizer. That sterilizer is monitored by an outside source...twice a month...to make certain it is working. Most hospitals and doctor's offices do this MONTHLY IF AT ALL. I mark every package with a lot number and write that down in an official log book. It is here for anyone to see.
That is far far far more documentation and proof than anything you can bring along may have, or anything you or anyone can buy.
If your artist cannot provide you with that, you simply need to go to someone who can. You need NOT go looking for your own needles, which defeats the entire purpose, and accomplishes nothing better.
There is not a legit tattoo artist in the universe that would use a needle you brought with you.

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Post by EvilJay » Sun Feb 03, 2008 12:08 am

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