Quality charter for the practice of Percutaneous Hydrotomy

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