Recommendations for Best Needling Practices with Respect to Skin Preparation

Abstract

The American Academy of Medical Acupuncture (AAMA) Board of Directors appointed this committee in April 2010 to address the issue of best practices for skin preparation prior to acupuncture treatment of patients. Extensive research produced three primary references and an additional twenty-three from McDaniels & Pittman (2011).¹ The committee's principal recommendations are those of this article. Additionally, Trachtenberg (1989)² and McDaniels (1995)³ provided an earlier foundation for the more comprehensive recent work. The committee intends these recommendations to be the core standards for best practices in skin preparation by physician acupuncturists.

The Academy's Board of Directors seeks to implement these recommendations through publication in Medical Acupuncture to the general membership and the medical community at large. This is a solicitation for comments about these recommendations. The comment period extends for 90 days after the date of publication.

Recommendations

Insert acupuncture needles only into clean intact skin.

For patients with intact immune systems, that is to say most patients, skin preparation with antiseptics is unnecessary and may be disadvantageous by creating an imbalance between normal resident bacteria and pathogens.

While definitive studies of the effects of the practitioner touching the needle shaft remain to be done, acupuncture needle characteristics, proper hand washing and drying by the physician before beginning each treatment minimize the risk of patient infections and justify the continued practice of touching the needle shaft.

For patients with compromised immune systems, skin preparation with chlorhexidine-alcohol or providone-iodine scrubs is superior to 70% isopropyl alcohol.

Universal blood and body fluid precautions (universal precautions) should be followed. When treating patients with a high risk of being infectious, the practitioner should protect himself or herself by using appropriate barriers, such as gloves or finger cots.

References

McDaniels

, Pittman

. Is skin preparation necessary before needling?: a review. Med Acupunct., 2011; 23,1:7–11.

Trachtenberg

. Acupuncture should be an unlikely mode of transmission for the human immunodeficiency virus (HIV) AAMA Rev., 1989; 1,1:6–8.

McDaniels

. Safe needles: recommendations for the prevention of disease transmission by medical acupuncture needles. Med Acupunct., 1995; 7,1:25–30.