Tattoo Sterilization vs Disposable Tattoo Equipment

Traditionally an autoclave sterilizer was considered to be indispensable piece of equipment that every reputable tattoo studio owned. Tattooists and piercers (or their apprentices) would spend many an hour soaking, scrubbing and cleaning their tools, prepping them to be bagged for the autoclave. Our sterilizers would then run their cycle, making our tools safe for use on the next client. Over the last 20 years a vast array of products adapted from the medical and dental industries have been introduced to our industry to augment and improve the cleaning regiment. Other tattoo savvy products have also sprung up to help us clean more safely and efficiently. To present even more options, many pre-sterile, single use, individually packaged products can now be added to our arsenal. Tattooers and piercers today are presented with an almost dizzying variety of tools for their trade.
When looking for a tattoo shop to patronize, some of our potential clients have been instructed by friends and family to ask to see the studio autoclave. Most of the “what to look for in a tattoo studio” or “things to consider before visiting a tattoo shop” articles recommend that the client ask to see the sterilization equipment. Until recently, every respectable shop had one. This idea has been widely challenged within the last 10 to 15 years. Specifically, in the last 5 years, we have seen a minority of studios dumping the ‘clave and going all sterile. Many shops now boast “completely disposable equipment” in their advertisements. We have seen a shift from the traditional popular opinion for some tattooers away from the traditional sterilization model. I wanted to explore some of the pros and cons of both sides of this argument.

A Stitch in Time
I sat down to write out some arguable points for both sides of this debate, and the first thing I scribbled was “saving time”. One major advantage of pre-sterilized tattoo equipment would certainly be more time to work. I think any successful shop (or any business for that matter) would agree time is money. Tattoos are often priced based on the amount of time the client will need to sit. If a busy artist spends 3 hours a week cleaning his equipment, and charged $100 per hour for tattoos, he or she would stand to earn an additional $300 a week by doing away with scrubbing, prepping, bagging and claving tools. More free time may yield more appointments. Even if that time was not dedicated to more tattooing, it would mean more time to clean the shop, help customers, prep artwork, or peruse Facebook (for the less ambitious). However the time was spent, most would agree that prepping tools for the ‘clave is not the best way to spend a Friday night.

First Impressions
The second pro for an all disposable setup would be savvier presentation. An all disposable shop would have less clutter. Cut out the ‘clave, and you cut out ultrasonics buzzing, dirty grips soaking, tubs or containers of tools waiting in piles, ‘claves needing cleaned, stacks of sterilization pouches, spore test strips, cleaning brushes, and the like. If you use a chemi-clave, you no longer need the chemicals. We can eliminate ‘clave cleaners, alconox, and whatever cleaner you prefer for scrubbing your grips. We also have now created a shop with less movement. No more running to the ‘clave room to get the right setup out of the last batch. Not only have you tidied up the shop and calmed it down, you have also lost the above expenses. Any successful business model will show that less cost means more profit.

Costs
This brings us to price. Traditional steel and nylon grips are reusable. Proper cleaning and the occasional replacement thumb screw, and a quality grip can last a long time. Traditional steel grip, tip, and tube combos average around $15 from most suppliers. Disposable combos run $.75 to $1 each on average. Switching from steel to pre-sterile would equate to buying a new steel setup every 12 to 15 sessions. Most artists think about the enormous added expense going disposable would likely bring. What most of us have not considered is how we would save more in other areas. For example, no sterile pouches, alconox, ‘clave cleaner, monthly spore test, and scrubbing cleanser. Gloves used during cleaning are not gone, no more tube brushes, gaskets and clave seals no longer need replaced. At our shops we take our ‘claves in for an annual checkup, which runs are $250 per ‘clave. Like a car inspection, our ‘clave is looked over to make sure everything is functioning properly. Add all these costs in with the amount of time per week spent cleaning, prepping, and sorting gear, and it is arguable that the increased costs of pre-sterile combos would be offset by the associated savings.

Hug a Tree
Many advocates of traditional sterilization cite the added waste associated with disposable grips. Bulky combos would fill up sharps containers and trash cans, causing more harm than good to the eco-system. I spoke with local recycling companies and was told that if properly organized and disinfected, plastic combos could be placed in recycling containers alongside water bottles and soda containers. The recycling process would insure than any contaminant would be more than eliminated, and the testing performed during the process is designed to catch and eliminate any anomalies. Whether pre-sterile or traditional, pouches are an unavoidable waste in the tattooing process. However the EO gas process that is popularly used with the plastic pre-combo does allow for smaller packaging than we often see used with traditional grips, so the waste may be a bit less for pre-sterile setups.

“If you want something done right, you gotta do it yourself!”
One of the strongest arguments against the use of pre-sterile tools is sterilization integrity. When using a pre-sterile item, we are left to only trust that our supplier is using a safe and sound process. Certainly no reputable supplier would conscientiously mislabel or cheat the sterilization process, but as an end user we ultimately have no way of guaranteeing the validity of the product without re-sterilizing. And that would completely defeat the purpose of buying pre-sterile. The only way to be sure an item was properly sterilized would be to be present for the entire process. However, as a reseller that has sold hundreds of thousands of pre-sterile grip and tip combos, needles, and tools, I feel more than confident in our line of sterile items. We use these products daily in our shop and sell them to shops all over the world.

“The Times They Are a Changin”
Traditional tattoo apprenticeships often involve the idea of paying your dues and showing respect to the tattoo industry. In some professional tattooers eyes, this means cleaning a lot of sh*t! If a shop were all sterile, would the impact of the apprenticeship on the student change? Some argue that by losing the autoclave we are also losing sight of part of the history of tattooing, and thereby undermining the integrity of the industry.

Old School
While it is certainly becoming a lost art as the years pass, there are still many tattooers who are jigging their own needles, mixing their own pigment, and the like. As more time passes these tattoo secrets may ultimately become lost in the myriad of pre-sterile, ready-made, mass produced products. Whereas 20 years ago a studio without an autoclave would be something to scorn, sterilization improvements have made the idea almost cutting edge. It is my personal opinion that the tattoo industry has been poised on a defining threshold for the last 15 years, a kind of industry revolution. Improvements in design, manufacture, and application have changed the industry dramatically. Some may say for better, others for worse but it is certainly an exciting time for tattooing. I, for one, am anxious to see what the future holds.

This debate ends with the same answer as many others in our industry. Tattooing and piercing are at their purest interpretive art-forms. There are many different brushes and paints that can yield beautiful results. The right tool is decided by the artist. No one tool works best for all artists. I think that whatever makes the tattooer feel most comfortable in delivering a quality piece of work is the best choice.

Paul Sorrels, CEO
info@razorbladeproducts.com
717 Tattoo & Body Piercing Studios – Two locations in Central PA – online at www.717tattoo.com
Razorblade Products, Inc – Tattoo, Piercing, & Medical Supplies by Professionals for Professionals, online at www.Razorblade.Pro

Body Jewelry Materials. Understanding Implant Grade Surgical Steel

Understanding Implant Grade Surgical Steel
For many years I have discussed and debated some of the common misconceptions our industry faces when it comes to the steel used in body jewelry. I hope to help shed some light on this subject, and share some of the research I have done. I am by no means a chemist, but the first time I reviewed a mill certification sheet, I wanted to know more about what was in the jewelry we were putting into our clients. Understanding the materials we use in our shops everyday allows us to better serve both our clients and our industry.
Currently the APP (Association of Professional Piercers) website states the following regarding acceptable steel types:
“Surgical Steel is made of a variety of alloys. Many of them are used for body jewelry, but only a few specific grades are proven biocompatible: steel that is ASTM F-138 compliant or ISO 5832-1 compliant; ISO 10993-(6, 10, or 11) compliant; or (EEC [European] Nickel Directive compliant.”
Taken from http://www.safepiercing.org/piercing/jewelry-for-initial-piercings/ under the Creative Commons Attribution-Noncommercial-No Derivative Works License

While I am not an APP member, the APP is arguably the most accepted voice for the piercing industry. So what exactly does this mean?
The American Society for Testing and Materials Standard (now ASTM International) is a volunteer-based organization with 30,000 members in over 120 countries. The ASTM determines standards for a myriad of industries, and has become the most definitive authority in this field. The standards determined by the ASTM dictate what materials can or cannot be used for any given application. Our industry seems to refer to their standardization more often than any other similar organization (AISI, ISO, et al).

Steel that is ASTM F-138 compliant is steel that has passed the criteria for implantation grade. The criteria for implant grade are based on the presence, or lack of presence of certain elements. The chart below shows the AISI, ASTM, and ISO chemical composition requirements for steel to be considered implant grade:

AISI max% ASTM max% ISO max%
Carbon .03 .03 .03
Manganese 2 2 2
Phosphorous .045 .025 .025
Sulphur .03 .01 .01
Silicon .75 .75 .01
Chromium 16.0-18.0 17.0-19.0 17.0-19.0
Molybdenum 2.0-3.0 2.25-3.0 2.25-3.5
Nickel 10.0-13.0 14.0-15.0 14.0-15.0
Nitrogen .1 .1 .1
Copper n/a .5 .5
Iron Balance Balance Balance

Now, if you have ever requested a mill certificate from your body jewelry supplier, some of this information may look familiar. It is interesting to note the near identical levels allowed by these three different standardization organizations. But, what exactly is a mill cert and what does it tell you?

For our purposes, a mill cert shows the result of a test that determines the chemical makeup of a batch of steel. If a body jewelry supplier consistently uses steel from the same steel manufacturer, a mill cert test will yield near identical results every time. The tests are done by a third-party lab, and the information is presented in the certification report. If the chemical makeup of the steel exceeds the allowed elemental percentages presented in the chart above, it no longer passes the ASTM F-138 standard, and is not implant grade. Failure to pass the ASTM F-138 indicates that the steel could pose a variety of problems if used for implantation purposes.

Every reputable supplier will be able to produce a mill cert, but the mill cert is only as valid as the supplier’s reputation. It is impossible to test every piece of jewelry a supplier carries. The mill cert is only relevant to the batch that was tested. If the steel manufacturer changes the “recipe,” any of the relevant elements could increase or decrease, causing unforeseen problems in the end result (body piercing). In truth, the best (and only) way to find out if a supplier’s body jewelry is up to par is to try it out. Consistency speaks more volume in our industry than any lab test or mill certification document, so find a supplier you are comfortable with, and stick with them. If you are considering switching suppliers, ask for third-party references, like another studio that buys and uses their jewelry. Our customers have been long-term, repeat buyers. This says an awful lot about our jewelry’s steel composition.

For many years the APP website listed 316LVM ASTM F-138 as the only acceptable type of steel to be used in body piercing. However, this was changed within the past few years and the site now states that F-138 compliant steel is acceptable. There are many types of F-138 compliant steel, but our industry finds 316L and 316LVM to be the best suited for the task. But what does 316L or 316LVM even mean?

The numbers are classification codes; and 316 is a classification code that follows 304. Code 316 steel is softer than 304 steel, which is often used to make pots and pans for use in kitchens. Lower tensile strength allows for increased mutability. This is another reason why 316 is used for body jewelry, as it is easier to shape. The “L” is used to signify “Low” Carbon content. In many instances 304 steel will pass ASTM F-138 tests, but due to the softness of the steel, 316 is preferred.

The “VM” stands for vacuum melted. This is a process that reduces what steel makers refer to as inclusions, tiny impurities that remain in the steel, often at a microscopic level. Vacuum melted also helps to remove the presence of sulfur, phosphorous, and other unwanted gases. There is no lab test that can prove that steel has been vacuum melted. Suppliers who place the VM classification on their steel are doing so by their own merit. Mill certification sheets that list the steel type as 316LVM are somewhat inaccurate. Mill testing should by definition be performed by a third party. If the cert says 316LVM, it has been adjusted by the supplier, or the steel manufacturer is also providing the cert. Either way, I would recommend a second opinion. Vacuum melting does not change the chemical makeup of the steel. It will show the same composition both before and after the vacuum melting process.
Good polishing is necessary for the finished product. Proper polishing of body jewelry minimizes any pitting or scratches, which gives the fresh piercing a higher probability of healing without complication.
I have seen or heard of many piercers and resellers advertising nickel-free steel. There is just no such thing. Steel is an alloy comprised of the elements in the above chart. All steel contains nickel, and as discussed, ASTM F-138 steel has low nickel content. Why is this important? Nickel is a natural allergen. Most people will have some visible skin irritation when exposed to metal with very high nickel content. While 316L and 316LVM have very low nickel contents, there is still a percentage of the population who will have a reaction. We recommend solid medical grade titanium in this case. This is titanium that passes the ASTM F-136 standard. This is the same kind of titanium used in major reconstructive surgery.

While we refer to steel as implant grade, it is important to address the reality that basic body piercings are not implants. Implants are completely contained in the skin. If steel that passes the ASTM F-138 standard is considered implant-safe steel, then 316L and 316LVM steel should be considered more than adequate for body piercing.
In my opinion, the steel is as good as the word of the supplier. Consistency is the key. Our piercers have been using the same steel from the same supplier for over five years. We have seen very few nickel allergies or rejections, and no discoloration. This hard data speaks louder than any mill cert.

How to Measure Body Jewelry

This article is from the Piercing FAQ, by Anne Greenblatt with numerous contributions by others.
2B.1 Jewelry Sizes

Jewelry is measured by gauge (thickness) and width. Rings are measured
by the inside diameter. Straight and curved barbells are measured by
the linear width from ball to ball. Most manufacturers offer widths in
1/16″ increments.

2B.1a Gauges And Equivalents

Most jewelry manufactured in the US is gauged according to the Brown & Sharpe system. Most jewelry from the UK and Europe is manufactured by metric gauge.

A visual representation of gauges and diameters is available at
http://www.cf.ac.uk/uwcc/psych/stevensonwc/bodyart/gauge.html

Brown and Sharpe Gauges (used by most American manufacturers)

--------------------------
gauge inches   millimeters
---------------------------
20    0.032    0.812
18    0.040    1.024
16    0.051    1.291
14    0.064    1.628
12    0.081    2.053
10    0.102    2.588
8     0.128    3.264
6     0.162    4.115
4     0.204    5.189
2     0.258    6.544
0     0.325    8.251
00    0.365    9.266