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3. Perform nasal prophylaxis. "There's some promising research about the
effectiveness of povidone-iodine nasal swabs in preventing Staphylococcus aureus
infections and we're waiting to see more data regarding the efficacy of the alcohol-
based nasal decolonization application," says Dr. Martinello.
Patients receive either form of nasal prophylaxis during the immediate pre-op
period, a factor that supports efficient workflow, says Dr. Martinello. "But we
don't have a full understanding of how Staphylococcus aureus infections occur,"
he says. "We do know the bacteria are found in nasal passages, so treating the
nose is important. But the bacteria are also present in other areas of the body, so
it's unknown if treating the nose with nasal povidone-iodine or the alcohol-based
application offers sufficient protection against infection."
Yale New Haven's surgical patients are prescribed 5-day treatments of
mupirocin nasal ointment and chlorhexidine gluconate baths to eliminate or min-
imize the risk of SSIs due to S. aureus. But Dr. Martinello acknowledges that it's
difficult to coordinate delivery of the prepping products to patients at least a
week before surgery and ensure full compliance, which is needed for the regi-
mens to be completely effective.
"It's not yet clear if we're able to transition to the simpler regimen of treating
the nasal passages on the day of surgery, but we look forward to seeing more
data on the effectiveness and durability of both options," says Dr. Martinello.
OSM
