Quick blog, but I am stunned not everyone is washing with surgical soap prior to surgery.
We always prep you in surgery to clean the skin prior to draping for the surgical procedure. The science is pretty clear that doing surgical washes at home prior to you coming in for surgery helps. I have my patients use chlorhexidine (has been shown to be better than betadine, and doesn’t turn your skin yellow) for days ahead of surgery.
Why do it?
- It is easy
- It is cheap
- It is good prevention
- If you are exposed to drug resistant bacteria (MRSA, found a lot in health care workers, gyms, and certain cities), it helps lower your surgical infection risk by cleaning your skin.
- It helps lower the NUMBER and TYPES of bacteria.
- The science is clear.
While doing my CME (continuing medical education- always learning!), one of the questions asked about this. It was referring to a nurse who had MRSA exposure, but I liked the info in the answer. If you are at risk for MRSA (nurse/medical care giver/doctor, history of prior MRSA infection, or you hang out a lot in sweaty gym changing rooms), you can get tested in your nose to see if you are a carrier. If you are, consider the following:
- Decolonization protocol from the Infectious Diseases Society of America is a combination of topical nasal mupirocin ointment (for the MRSA) and a chlorhexidine body wash for 5 days.
- Most of this data comes from cardiac surgeons, who do prophylaxis for all patients having heart surgery. These guidelines are based on studies that show a decreased rate of sternal wound infections.
- MRSA rates in health care workers is 5% based on large review studies.
- A lot of the MRSA cases come from nasal colonization, routine screening and decolonization are recommended in areas where the carriage rate exceeds 10%.
Chlorhexidine brands: Betasept, Biopatch, Calgon Vesta, ChloraPrep One-Step, Dyna-Hex, Hibiclens, Hibistat Towelette, Scrub Care Exidine, Spectrum-4
Not to sound like a bumper sticker, but prevention is the best medicine.
So hop in that shower.