Park and Shim described a female patient who had countless acupuncture needles left in her body, especially around paraspinal muscles.1 They stated that “this subtype of acupuncture known as Hari involves the permanent placement of fine needles into the subcutaneous tissue,” but this is not correct.
The Japanese word Hari means sewing needle, acupuncture therapy or acupuncture needle. When we use this word to mean acupuncture therapy, it means acupuncture in general. Referring to a paper by Vassiou and colleagues,2 Park and Shim explained that the retained needles are typically 1 mm in diameter, but this is also incorrect. The diameter of retained needles is the same as that of acupuncture needles usually used in Japan: between 0.14 and 0.20 mm.
In Japan, we usually use the word Maibotsu-Shin for embedding acupuncture needles, but this practice is not performed anymore because it has caused many adverse events.3
As with the evaluation of efficacy in evidence-based medicine, the safety of acupuncture should be assessed through prospective surveys or controlled studies that show incidence, degree of severity and significance of differences wih control groups. Recent large-scale prospective surveys in Germany involving about 200 000 patients show that serious adverse events of acupuncture are very uncommon,4,5 but some do occur. We continue to provide all those who perform acupuncture with updated information for safer practice.