Preoperative Preparation for S. aureus or MRSA Carriers



What is S. aureus?

 

S. aureus is the short name for Staphylococcus aureus.  S. aureus is a type of bacteria (germ) that lives on the skin and in the nose of some people.  It rarely causes any problems.  All humans carry bacteria on our skin, in our nose, and inside our digestive tract.  In most cases, they do not harm us and are often very helpful.  But if bacteria get into a part of our body where they don't belong, they can cause problems and lead to infections.

 

What is MRSA?

 

MRSA is the short name for Methicillin Resistant Staphylococcus aureus.  It is a type of S. aureus germ that can be very hard to treat with medicine when an infection occurs.  Some people carry this type of S. aureus on their bodies or in their noses without any problems or infections.  But if MRSA gets into a part of the body where it doesn't belong, it can cause problems and lead to an infection that is hard to treat.

 

MRSA and Isolation Precautions

 

If you are found to carry MRSA, special safety measures will need to be followed. This prevents the spread of MRSA to other patients.  These safety measures are called contact isolation precautions.  To prevent the spread of MRSA, your visitors and health care workers will follow directions outlined in a sign placed on your door while you are in the hospital. 

 

Health care workers and visitors will

• Clean hands and wear gloves and gown when going into your room. 
• Put used gloves in trash and gowns in hamper.  Then clean hands again before leaving your room. 
   

You will be asked to

• Talk with your nurse about what you need to do to prevent the spread of germs. 
• Cover your mouth and nose when sneezing or coughing.  If you use a tissue or your hands, clean your hands when you are done. 
• Clean your hands before leaving your room. 
• Put on a clean robe (may use a second gown worn like a robe) before leaving your room.  Keep the robe on while outside your room. 
• Stay in your room except when you need to go for a test or procedure. 
• Avoid contact with other patients.

If you are found to carry MRSA, University of Wisconsin Hospital and Clinics (UWHC) requires you to be in contact isolation for your entire hospital stay.  You will be in contact isolation every time you are a patient in a UWHC hospital or clinic at the hospital.  To change this procedure, you will need to get three more sets of nasal and skin swabs.  All swabs must show that you do not have MRSA anymore.  Please talk with your health care provider to learn more about these MRSA clearance swabs.

 

Having MRSA in your nose or on your skin should not be a problem in your daily life.  The best way to prevent the spread of MRSA at home and in public is to wash your hands often.  You should also wash objects often that you touch a lot.   If you are concerned about carrying MRSA, ask your health care provider what can be done to help get rid of it.  There are medicines that may help reduce MRSA germs on your skin.  For some people, medicine gets rid of the MRSA germs from their bodies.  Other people carry MRSA on their bodies for many years.

 

What can be done to prevent an infection at my surgical site if I am found to carry S. aureus or MRSA?

 

If you are found to carry S. aureus or MRSA or are likely to carry these bacteria due to your health history, you will be asked to follow the directions below.  They will reduce your risk of a S. aureus or MRSA infection at your surgical site.

 

1. Apply an antibiotic ointment to your nose twice per day for the 5 days before your surgery.
2. Wash with a special antibacterial soap called Hibiclens® daily for the 5 days before your surgery.*  On the day before surgery, wash with Hibiclens® in the evening.  Also wash with Hibiclens® on the morning of your surgery before you leave home.
3. An antibiotic will be given to you in the hospital before your surgery that works against S. aureus or MRSA.

 

Special preoperative directions can be found on the next page.  You must follow these.  Contact your doctor if you have questions.

 

 

 

University of Wisconsin Hospital and Clinics

Preparing Your Skin before Surgery - S. aureus/MRSA

 

Name__________________________ Surgery Date___________ Surgery____________________

 

Directions

 

5 Days before Surgery

Complete these steps daily from the 5 days before surgery until the day before surgery.

1. Wash hair and face as usual.  Rinse hair and body.  Wash gently for 3 minutes with Hibiclens® from chin to toe.  Rinse thoroughly.  Keep Hibiclens® out of eyes, ears, and mouth.  Do not use on the head, face, genitals, or rectal area.
2. Apply a generous amount of mupirocin with cotton swab to each nostril two times per day.  Do this after washing in the morning and at bedtime.

Shaving at the surgical site should be stopped at least 2 days before surgery.

 

The Night before Surgery

• Wash as described in step 1 above. 
• Dry skin with a clean towel.  Do not apply lotions, moisturizers, or makeup.
• Apply mupirocin a second time as described in step 2 above.

 

The Morning of Surgery

• Wash as described in step 1 above. 
• Dry skin with a clean towel.  Do not apply lotions, moisturizers, or makeup.
• Do not apply mupirocin on the day of surgery.

Wash daily with Hibiclens® avoiding the head and face

Apply Mupirocin ointment to each nostril twice per day.  Do not apply on day of surgery.

 

*Hibiclens® is for skin use only.  Do not use if you are allergic to chlorhexidine gluconate (CHG).  Do not use in the genital or rectal areas.  Do not use on the head or face.  Do not use on deep wounds.  CHG may cause skin irritation such as itching or redness.  This is more likely when it is applied to sensitive skin right after taking a shower or shaving.  If itching or redness persists, rinse the affected areas.  Stop using the Hibiclens®.  Contact your surgeon's office.

 

The Spanish version of this Health Facts for You is #7221.

 

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 06/03/2011

Copyright © 05/25/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #7218

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