Sterilization
Sterilization is a procedure which completely eliminates all forms of microbial life. Sterile means free of living microorganisms (microbes); that is, an absence of viruses, bacteria, and fungal spores. In professional body modification studios is crucial that all equipment is properly sterilized in an autoclave (although in some situations chemical sterilization also works), and all non-porous surfaces are thoroughly cleaned with a germicidal solution to minimize cross-contamination and protect the client.
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Methods
Autoclave
An autoclave is generally considered to be the only form of sterilization appropriate for a body modification studio, although some low-volume home studios may use chemical sterilization. It should be noted that cleaning is the most important part of sterilization - unclean tools may not sterilize properly.
An autoclave sterilizes through a combination of pressure and heat. While it might be difficult to justify the cost if you're just piercing yourself or your fluids-exchanged partner from time-to-time, there is no excuse for not using an autoclave if you're piercing friends. A used autoclave can be bought for a few hundred dollars. No special paperwork is required to buy them—consider them essential.
That said, as with all things, you have to use them properly. They must reach and sustain the required heat and pressure. They must be packed properly. They must have water in them. They must be spore tested from time to time (to make really sure they're working).
A studio which does not employ proper sterile techniques should be always be avoided.
Flaming
Using a flame to sterilize a needle or other body modification implement is generally considered unacceptable. There is little real world data available on the effectiveness of direct flame in killing microbial life, and when it comes to items that break the skin, the only context in which flaming is still used is in cases where a needle has to be reused immediately and there are no other options (i.e. no time to implement other methods of sterilization — even boiling is better — and no new needles are available). It is only used when absolutely no other options are available.
An autoclave is generally considered to be the only form of sterilization appropriate for a body modification studio, although some low-volume home studios may use chemical sterilization. It should be noted that cleaning is the most important part of sterilization - unclean tools may not sterilize properly.
A studio which does not employ proper sterile techniques should be always be avoided.
Boiling
Boiling water is generally unable to fully sterilize jewelry, needles, or other body modification equipment. Boiling water is 100 degrees Celsius. Although this will theoretically kill most organisms other than endospores and some viruses in half an hour, because endospores are not killed and the consistency is poor, no health boards consider boiling as a viable form of sterilization.
The CDC has permitted boiling of needles and medical tools for an hour in extreme cases in areas where autoclaves and other more functional methods are not available. They emphasize the additional difficulty of controlling contamination from the containers for the boiled items, as well as the tools used to transfer them (since you can't boil something inside an autoclave bag). After the item is boiled it is then transferred to a sterile field to dry, and then placed in a sterile container if possible.
It should also be pointed out that while in theory boiling mostly works, in real-world tests at dental clinics still using boiling as their method of sterilization in the 1980s, staphylococcus bacteria were found on tools that had been boiled - and this is one of the most common bacteria linked to infections - in body piercings. Other studies have shown that boiling water may not always even disinfect (British Dental Journal, 1985, #159).
It must be emphasized that boiling as a sterilization procedure is not recommended and is utterly unacceptable in a professional context.
For self-piercing: This might be an acceptable way to clean tools and jewelry that have been used on either no one or only on you, but this is definitely not an acceptable way to clean tools that have come in contact with anyone else.
You can take this a notch up by using a pressure cooker (since one could argue that a steam autoclave is essentially just a fancy pressure cooker). However, realize that because a pressure cooker doesn't have the gauges and monitoring ability that an autoclave does, you'll never really know how effective your sterilization cycle was.
Bleach
Bleach is far a more powerful anti-microbial agent than alcohol. Drug treatment clinics regularly advise addicts to immerse their syringes in a thinned down bleach solution. However, they are starting to move away from this because the bleach kits often don't kill Hepatitis, and sometimes don't even kill the AIDS virus.
Rubbing Alcohol
Rubbing alcohol will disinfect and to some extent sterilize. However, most of the microbes we worry about (things like Hepatitis) aren't going to be killed using rubbing alcohol. Rubbing alcohol might be a marginally acceptable way to clean your own supplies, but if these supplies have been handled by or used on anyone else, alcohol isn't going to cut it. That means that if you use a pair of clamps to pierce a friend, that alcohol isn't going to get rid of germs.
Chemical
Chemical sterilization using gluteraldehyde based chemical agents is an effective way to sterilize in a home studio environment, but care must be taken to follow the instructions precisely. A common mistake people make is not leaving the tools in the chemical bath long enough because they contaminate the bath by adding additional tools part way through the cycle.
Piercing in the Field
The piercers must to have access to hot and cold running water. As for field preparation, it is best to work off of smooth, hard surfaces that can be easily cleaned and then covered with disposable surfaces such as dental bibs. The biggest problem with field suspensions is limited supplies and cross contamination. The piercers must be very careful to separate the fields into clean, working, and contaminated areas.
