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Is it okay to use re-usable needles insted of disposable ones?

Q: I had acupuncture today, the lady used re-usable needles instead of disposable ones. She assured me they were sterilised using the appropriate machine. Is this ok?  Shouldn't all acupuncture needles be disposable?

A:  The BAcC's Code of Safe Practice could not be more explicit on this:

You must only use single-use pre-sterilised disposable solid needles which, if in multipacks of five, ten or more needles, must not be used or stored for use after the session in which the seal on the package is broken. Any needle with damaged packaging seal must not be used.

The only exceptions which we ever allowed were when the transition to guide tube needles was introduced in the late 1990s and some of the longer needles were not available at that stage. We allowed members who purchased these to use them only after they had been sterilised before use and then only used a single time as if they were single-use needles. In modern times all sizes are available as single use needles and there is no excuse for re-using needles.

The ban on the use of re-useable needles was introduced for safety reasons. It transpired that prions, the proteins involved in the transmission of Variant CJD, the 'mad cow' disease human equivalent, were not killed by autoclaving, and there was always a theoretical risk that someone could unwittingly spread the disease by needle re-use. Subsequent investigation revealed that it required more than simply exposure to the prion to create the condition in another subject, but by this stage the change to single use needles had become firmly established and patients and practitioners alike were reassured by the safety that this provided. The growing market also meant that needle prices dropped and quality improved, where the earlier disposables had been shockingly poor. Nowadays a needle can cost as little as 2p, and there really is no justifiable reason not to use single use needles.

If the practitioner is a BAcC member, you would be well advised to report them to the Professional Conduct Officer or Safe Practice Officer immediately. The chances that you have been put at risk are minimal, but that does not change the fact that this is a breach of one of the more strict rules under which we operate. If the practitioner is not a BAcC member, you should take the matter up with their professional body, or should that not be something you want to do, then you could contact the local authority Environmental Health Department. The law relating to skin piercing does embrace the possibility of re-using needles, but this is because the new byelaws were extended to covering all skin piercing and many tattooists and body piercers do use re-useable equipment. Had it been an acupuncture-only law, we would have insisted on single use disposable equipment being the legal norm. If someone is re-using needles, then their autoclaving equipment has to be maintained in an exemplary fashion to guarantee that it delivers what it is supposed to.

Aside from anything else, inserting a needle can do considerable damage to the point, as this recently published paper shows

and creating small fish-hook ends which go in easily but tear tissue on the way out is not a great option for patients. Needle breakage is almost unknown in modern times, but where this used to happen in the old days, it was usually related to the over-use of needles with autoclaving which made the steel become more brittle. Single use needles have all but eradicated this problem.


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