Quality charter

Never perform percutaneous hydrotomy without prior training in the technique.

1) OBLIGATORY training:

• Attendance at a theoretical and practical workshop for doctors, nurses, and healthcare professionals.

2) Online list of practitioners:

Registered only in France and restricted to doctors, registered nurses with a single occupational address and telephone number (annual subscription for inclusion = €30)

• Other healthcare professionals undertake the practice entirely under their own medico-legal responsibility for the country where they are practising.
• For those outside France, inclusion of practitioners for information purposes: practice in accordance with the legislation in their country of practice.

3) Installation of the treatment room:

• Appropriate and clean premises
• Information on the technique available in the waiting room
• Examination table
• Drip holder
• Single-use material: syringes, needles, mesokit
• Availability of all the products necessary for percutaneous hydrotomy

4) Strict aseptic technique:

• Disinfection with 70° alcohol or Septeal
• Disinfection of hands or gloves

5) Strict compliance with the protocols taught

6) Never use alternative products (substitution) or add ingredients:

• Risk of unknown physico-chemical incompatibility: pH, viscosity, osmolarity, pain at point of injection, poor resorption, risk of nodules or even necrosis.

7) Adhere to extensive dilutions

Primarily for the following products:

• Soluvit
• Decan or Nutryelt
• EDTA (acidity)
• Ketoprofene

Second, comply with the injection techniques:

• Mesochelation protocol by continuous injection
• Vaso-active protocol as discontinuous +++, layering or 3-second technique (procaine: never more than 2 mL, Mag, Soluvit, pentoxyfilline, ketoprofen)
  never inject into the feet or hands

8) Do not perform or associate with the session (before or after) new technical manipulations that were not part of the training

• Including application of non-sterile creams, apart from EMLA 5%, massages, etc.

9) It is forbidden to use products without MA 

• Quinton plasma is a nutritional supplement and does not have market authorisation (MA) for injection, contrary to information sometimes published on the internet (“guerilla” hydrotomy).

10) No manipulations of perfusion pouches

• Beyond normal use and use of extemporaneous products (limited shelf-life of injectable products).

11) Monitor the patient

• Be reassuring
• Take feedback from the patient into consideration: pain at the point of injection (reduce the pressure on the syringe or the perfusion flow-rate).
• Take individual sensitivities into consideration: anxious nature, spasmophilia, older age (half-dose) to avoid overloading with local anaesthetics.

12) Adherents to the charter must respect certain ethical considerations to avoid exclusion:

• Conformity with the Percutaneous Hydrotomy nomenclature (avoid any other terms).
• Expressing opinions or personal criticisms on the practice of this technique by healthcare professionals beyond any consultation or decision from the Society.

13) Price of consultation within a reasonable range:

• Doctors
  – Intradermal injection: €30 to 50
  – Mesoperfusion: €50 to 80
• Nurses
  – Intradermal injection: €20 to 30
  – Mesoperfusion: €30 to 50

14) The Quality charter for the practice of Percutaneous Hydrotomy must be:

• Dated and signed