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Rover -> RE: Medical and Edge Play and Safety (10/27/2007 4:14:52 PM)
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Several years ago I attended a workshop presented by a Doctor of Microbiology whose background includes medical and theoretical research at both the hospital and university levels, and who (at the time) currently teaches at a major US university. All credit for this information (at least that which I will correctly relate) should go to Dr. Grex who conducted the workshop.
I don't make it a practice to regurgitate what I have learned elsewhere, especially from workshops and demos that really should be attended in person. However, the nature of this particular workshop is so compelling that I thought it would be helpful to the community as a whole to at least hear about the major topics covered. I know that I learned quite a bit about being able to play safely, and to ensure that continued safety through adequate methods of cleaning toys and equipment.
The workshop first covered the difference between:
Sterilization: The destruction or removal of all living cells, spores and viruses.
Disinfection: Inhibiting, destroying or removing microorganisms that may cause disease.
Sanitization: The reduction of microbial population to levels considered safe by public health standards.
As might be expected, attaining those various levels of cleanliness involve different processes and are more difficult to achieve as the level of cleanliness increases.
We're all familiar with sanitizers, such as those found in some household hand cleaners, surface cleaners, etc. We've even seen disinfectants that contain materials such as bleach. But sterilizers are another animal altogether, and not something that we typically look for. I think most people thought just as I did prior to this workshop; that disinfectants would do the job nicely. How wrong I was.
Let's go through the process of first determining what items need which level of cleanliness, how to choose an object for purchase with cleanliness in mind, and then how to achieve it.
The level of cleanliness that must be attained (ie: either sterile, disinfected or sanitized) depends upon how it is to be used (whether it simply comes in contact with the person, or is actually inserted into the person). Knives, needles, dildos, speculums, etc. that are to be inserted into the body (either through an orifice or through the skin) demand sterilization. Any amounts of microorganisms that may remain on those surfaces pose a substantial threat to health and safety. Surfaces and toys that come in contact with bodily fluids such as blood or semen, but will not be inserted into the body, require at least disinfection. And surfaces or toys that come in contact with the body, but do not come in contact with bodily fluids and are not inserted, require at least sanitization.
The ease or difficulty of attaining those levels of cleanliness will depend in large part upon the type of material that an object is made of. For example, glass or metal objects are much easier to clean than leather or wood objects that, on a microscopic level, contain numerous pits, valleys, nooks and crannies that may harbor infectious microorganisms. Additionally, the methods for killing microorganisms also tend to destroy toys that are made of less durable materials, such as wood and leather.
Consequently, cleanliness and safety begins when you first purchase a toy, by ensuring that the material it's made of is conducive to being able to properly clean it after the activity you intend it for. That leather dildo, for example, may look really exciting. But because it's a toy that is inserted into the body and could pose a threat of infection, it must be sterilized after each use. And that leather is going to be infinitely more difficult to sterilize than glass, plastic, rubber or some other materials. On the other hand, a leather table that might come in contact with you during a scene does not require sterilization, since it will not be inserted into the body. Disinfection or sanitization (depending upon whether or not it comes in contact with bodily fluids), is sufficient. Unless the table may somehow become inserted into the body, which isn't likely, and if it is I want pictures.
The next step is to determine whether an object is for a single use only. Objects such as needles should be disposed of after each use. Obviously, things such as knives or toys are used repetitively. But even those items should be used ONLY on one individual, and not shared amongst others. Any item that requires sterilization (ie: it will be inserted into the body) should either be a single use item, or a single person item. No exceptions!!
We're all familiar with the use of sanitizers. They're found in hand cleaners, surface cleaners, etc. Cleaning a play surface is no different than cleaning other surfaces in our homes that we come in contact with. The same thing is true with disinfectants that we use to clean surfaces that come in contact with body fluids (ie: what is used in bathroom/toilet cleaners) and food preparation surfaces. Generally speaking, those disinfectants contain bleach. Ethanol alcohol is another good disinfectant, with an optimal concentration of 75 %. Check the label. Soaking for 10 to 15 minutes is sufficient to disinfect small instruments.
Sterilization for those items that will be inserted into the body is infinitely more difficult to achieve. Contrary to some popular misconceptions, boiling water is NOT a sterilizer. Alcohol is not a sterilizer. Bleach (or chlorine) is not a sterilizer. Iodine and hydrogen peroxide are not sterilizers. A microwave is not a sterilizer. The refrigerator or freezer is not a sterilizer. Passing an object through a flame does not sterilize it.
There are a variety of methods to achieve sterilization. Most require expensive equipment, and are inappropriate for objects other than metal, glass, etc. because in the process of destroying microorganisms, they also tend to destroy leather, fabric, plastic, etc. Following are two methods of sterilization that do work, and are commonly available to most of us.
One method of sterilization that's in wide practice within the medical community is an autoclave. An autoclave uses high, prolonged heat to fully sterilize glass and metal objects. If you play with knives, speculums and other such objects, there may be a facility nearby where you can have those toys sterilized. Check the yellow pages. I'm also told that some facilities advertise over the internet. The same results can be achieved using an oven, in which the objects are wrapped in tin foil (do not remove the tin foil until the object is to be used again, as that will expose it to microorganisms) and heated to temperatures of 320 to 340 degrees Fahrenheit for two to three hours. Longer if the object is large. Heat sterilization is obviously limited to those items that will not be destroyed by the heat itself.
Another method of sterilization that can be commonly found is glutaraldehyde. Gluteraldehyde in a 2 % solution used in a ten to twelve hour immersion is a very effective chemical sterilizer. It's available over the counter under a variety of brand names wherever medical supplies are sold (ie: drug stores, etc.). Check the label to make sure what you're getting!!! Always remember to give things a quick bath in sterile water (no, not tap water) to remove any residue. Remember, these objects are going to be inserted into the body, and you don't want to introduce any chemical irritants.
No matter which method of sterilization that is chosen, it's recommended to use a quick alcohol bath and allowing the object to air dry immediately before use.
Please note once again that both methods of sterilization are best used on metals, glass, plastic (in the case of gluteraldehyde) etc. It's best to show some real thought before using an object in a manner that's inappropriate for the material it's made of.
As a disclaimer, I want to reiterate that I am not a medical professional. I've written this piece entirely from my recollection of the workshop I attended, and from the notes and handouts from that workshop. So if anyone is a medical professional, PLEASE feel free to make any corrections or additions to the information I've related.
John
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