Dry Needling…To swab or not to swab?

Dry Needling...To swab or not to swab? The question of whether to swab or not to is an interesting one. Many therapists who use Dry Needling still use swabbing as a means of sterilising a patient’s skin and reducing the risk of infection.

Personally I don’t use swabs except in two types of patients:

  1. Immunosuppressed patients
  2. Patients with soiled skin
The reason I don’t swab is based on my research into this question. While preparing my online Dry Needling programs I needed to justify why I didn’t swab rather than use empirical and baseless information.

I came across the paper by Hoffman P: Skin disinfection & Acupuncture (2001). Acupuncture Med. 2001 Dec;19(2):112-6.

In this paper Hoffman explains why swabbing is not required and the basis behind the findings.  

Here’s the abstract…

The need for skin disinfection before insertion of an acupuncture needle is controversial and there is no specific research on this topic. However research and observations on the effect of, and the need for, skin disinfection before injections forms a good analogy of acupuncture. 

Whilst micro-organisms present on the surface of the skin are accessible to disinfection, those located under the surface in ducts, glands and follicles are out of reach and can be inoculated into the sterile tissues below by needle insertion. 

Fortunately, the bacteria resident on the skin have a low potential to cause infection if host immunity is not severely impaired or compromised by the long-term presence of foreign material, such as a surgical stitch. 

Disinfection of clean skin before injection is not generally considered necessary and observations of lack of infection following injections without prior skin disinfection support this; however, contamination by micro-organisms not normally resident on skin can pose a higher risk of infection. 

If skin is visibly soiled, it should be washed and if needle insertion is near an infected or contaminated site, it should be disinfected with alcohol. Practitioner hand hygiene between patients is important, even if gloves are worn. Hands should be washed with soap or detergent and water, or an alcohol handrub can be used if hands are physically clean.


Dr Wayne W Mahmoud
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