Recommendations for Best Needling Practices with Respect to Skin Preparation *

Abstract

The American Academy of Medical Acupuncture's Board of Directors seeks to promote the highest standards of practice for medical acupuncturists. The Board addresses the issue of best practices for skin preparation prior to acupuncture treatment of patients by adopting the following recommendations after (1) initial recommendations by its Best Practices Committee, (2) disclosure of these recommendations through their publication in Medical Acupuncture, (3) request for and receipt of peer review of the initial recommendations, (4) revision of the recommendations by the Best Practices Committee, and (5) approval of these revised recommendations by the AAMA Board of Directors.

Recommendations

1. Insert acupuncture needles only into clean intact skin.

2. 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.

3. While definitive studies of the effects of the practitioner touching the needle shaft remain to be done, the acupuncture needle's innate biophysical electric charge, and 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.

4. For patients with compromised immune systems, skin preparation with chlorhexidine-alcohol or providone-iodine scrubs is superior to 70% isopropyl alcohol. If intra-articular needling is indicated, the practitioner should consider the same skin preparation and appropriate barriers, such as gloves or finger cots.

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

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