PDF Preventing Infection after Surgery: Patient Instructions ...

Preventing Infection after Surgery: Patient Instructions Screening for Bacteria before Surgery

We are testing you today for Staphylococcus aureus bacteria (Staph) by placing a swab in your nose. Staph is a bacteria (germ) that lives in the nose and on skin. Many people have it and don't know it. If you do have staph, there are special things you need to do to reduce the chance of getting an infection with this germ after surgery. You can reduce the chance of getting an infection by using a medication ointment (Mupirocin) in your nose and an antiseptic body wash (known as chlorhexidine or by its trade name, Hibiclens?). Your surgeon's office will call you to tell you your result and to review the instructions you should follow below.

If the test shows that you DON'T have staph, follow these instructions: What I need to do: 1. Skip to page 3 for bathing instructions.

If the test shows that you DO have staph, you will be asked to follow these instructions:

What I need to do: 1. I need to fill my prescription for Mupirocin (nose medicine). 2. I need to get clean cotton swabs. 3. I need to start using Mupirocin 5 days before my surgery. I will follow

instructions below on Page 2. 4. Then, I will follow bathing instructions on page 3

Updated: 2 May 2014

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Nasal (nose) medicine: Use this medicine for 5 days before your surgery and the day of your surgery for a

total of 10 doses. Apply your first dose in the evening 5 days before your surgery. Then use twice a day, once in the morning and once at night for 4 days. Apply your last dose the morning of your surgery. Do not use this if you have an allergy to Mupirocin. The instructions on the package will say not to apply to the nose. Please disregard this.

My medication schedule: (write dates in blanks)

My surgery date:

______________

5 days before surgery: ______________ apply one dose in evening

4 days before surgery: ______________ apply one dose in morning and evening

3 days before surgery: ______________ apply one dose in morning and evening

2 days before surgery: ______________ apply one dose in morning and evening

1 day before surgery: ______________ apply one dose in morning and evening

Surgery day:

______________ apply one dose in morning

How to apply Mupirocin:

1. Wash your hands very well. 2. Put a pea-size amount of ointment onto a cotton swab. Insert the cotton swab about

1/4 inches into the nostril and apply the ointment. 3. Remove the cotton swab. Close the nostril by pressing the sides of the nose together

and releasing. Massage the nostril in this way for one minute to spread the medicine evenly throughout the nostril. 4. Use a new cotton swab and do the same thing to the other nostril. 5. Wash the skin below your nose to remove any remaining medicine. Wash your hands. 6. Do not touch your eyes. If the medication gets into your eyes, it may cause burning and tearing. If this happens, rinse your eyes well and call your doctor.

If your surgery is postponed, stop your medication schedule above.

If your new surgery date is more than 2 weeks away, start the whole schedule again 5 days before your new surgery date.

If your new surgery date is less than 2 weeks away, continue your medication schedule where you left off. For example, if you took medication for 2 days before stopping, restart the medicine 3 days before your new surgery date.

If you are unable to complete the process, please tell your surgeon.

Updated: 2 May 2014

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Bathing with antimicrobial soap to prevent infection after surgery:

You can also reduce the chance of getting an infection by showering with an antimicrobial soap chlorhexidine (Hibiclens?). This is true for all patients, even those who do not have staph. We will give you Hibiclens? during your pre-operative visit. The number of days you use it depends on the results of your nose swab test.

I don't have staph: Use the Hibiclens? soap on the two days before your surgery, and on the day of your surgery (once a day for 3 days). The last shower should be on the day of your surgery, but if you can't do it that morning, you can shower the night before.

I do have staph: Use the Hibiclens? soap on the four days before your surgery and on the day of your surgery (once a day for 5 days). The last shower should be on the day of your surgery, but if you can't do it that morning, you can shower the night before.

What I need to know about Hibiclens? before I shower: Use Hibiclens? soap instead of your regular soap. Do not use both. If you do, the

Hibiclens will not work correctly. Do not use Hibiclens? if you have an allergy to chlorhexidine-containing products. If

you do, you may use an antibacterial soap instead (like Dial antibacterial soap). Do not use Hibiclens? on your head or face. If you get this soap in your eyes, flush

with water right away. Do not use Hibiclens? on the vaginal area.

How to shower with Hibiclens?: Do not follow the directions on the Hibiclens package. They are meant for surgeons. Follow the instructions below:

1. First, rinse your body very well with water. 2. Turn the water off. 3. Wash with the Hibiclens? from the neck downwards. Wash the part of your body

(hip, knee, etc.) where you are having the surgery very well. 4. Wash your body gently for five minutes. Do not scrub your skin too hard. You can

use a sponge to help with lathering. Hibiclens? does not lather as well as regular soap. 5. Turn the water back on and rinse well. Pat dry with a clean towel.

If you develop a rash or skin irritation, please call your doctor. If you get hives or have trouble breathing, call 911 or go to your nearest emergency department.

More instructions: Do not shave for 24 hours before your surgery. The day of your surgery, do not put on powder, lotion, deodorant or hair products.

Updated: 2 May 2014

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