Wrightington Elective Hip/ Knee Replacement MSSA Skin Decolonisation Pathway

Wrightington Elective Hip/Knee Replacement MSSA Skin Decolonisation Pathway

Patient Information

Trauma & Orthopaedic Surgery Department

• Author ID:           JB
• Leaflet Number: Musc 060
• Version: 2
• Name of Leaflet:  Wrightington Elective Hip/Knee Replacement MSSA Skin Decolonisation Pathway 
• Date Produced:  June 2024
• Review Date:    June 2026

Introduction

This leaflet has been written to tell you about Methicillin Sensitive Staphylococcus Aureus (MSSA) skin decolonisation treatment before you are admitted to hospital for your Hip or Knee replacement surgery.

What is MSSA?

MSSA is a type of bacteria (germ) often found on the skin and in the nose of healthy people – approximately 50% of the healthy adult population at any one time. Usually this germ is harmless. MSSA is a common cause of localised skin and soft tissue infections. These infections are normally mild and easily treated.

MSSA can also lead to more serious soft tissue infections and is a common cause of infection in joint replacement surgery (prosthetic joint infection). Research has shown that interventions – such as decolonisation using nasal gel and body washes – can reduce the risk of prosthetic joint infection from MSSA by 60 per cent in some cases.

Why do I need MSSA skin decolonisation?

This simple intervention can help to lower the risk of you developing a prosthetic joint infection after your joint replacement surgery. It is recommended by the National Institute for Health and Care Excellence (NICE).

What is the treatment?

You have been provided with the MSSA skin decolonisation pack at your preoperative assessment appointment. Detailed instructions for use are included below. Please follow these instructions carefully, to maximise successful treatment.

How long does the treatment last for?

You should use the MSSA skin decolonisation treatment pack (nasal gel and body wash) for 5 days before your date of surgery. The last day of use should be the morning of your surgery.

If you are brought in at short notice, a member of our team will contact you to inform you to start using the MSSA skin decolonisation treatment pack immediately, and we will continue this in hospital after your surgery to ensure you get the full 5 days of treatment.

Instructions for patients using Chlorhexidine 4% body wash

Note: this must not be used by patients with an allergy to soya, peanuts, chlorhexidine or any of the other ingredients in the product.

You should bathe (bed bath/bath/shower) for five consecutive days with the body wash. This includes washing your hair. Use the body wash as a liquid soap, undiluted.

• Ensure skin is wet all over then apply 30mls (about two dessert spoons or an egg cup full) of the body wash directly onto your skin using a wet, disposable cloth
• Pay particular attention to your hair, around the groin, perineum (around the anus), buttocks, armpits, inside any other skin folds and your feet
• Leave the body wash in contact with your skin for 1 minute. Then rinse off from head to toe
• Wash your hair using the body wash on Day 2 and Day 4, again allowing contact for 1 minute before rinsing through. You may use your usual hair conditioner products after if desired
• Dry yourself using a clean towel. This towel should then be washed using your usual washing detergent
• Put on a clean set of clothing after
• It is advisable (if possible) that you use clean bed linen every day during your decolonisation treatment

To be completed by patient daily during treatment. Remember, Day 5 should be the morning of your operation (unless told otherwise):

Chlorhexidine 4% Body Wash

Instructions for using Mupirocin 2% Nasal Ointment 

Note: this should not be used by patients with an allergy to mupirocin or any of the other ingredients in the product. 

Apply three times per day (morning, afternoon and evening) for five consecutive days.

• Place a small amount of nasal gel (about the size of a match head) on a cotton bud or on the little finger and apply to the inner surface of each nostril
• The nostrils should then be closed by pinching the sides of the nose together at each application as this spreads the ointment throughout each nostril

To be completed by patient daily during treatment. Remember, Day 5 should be the morning of your operation (unless told otherwise):

Mupirocin 2% Nasal Ointment

Lastly, please bring this signed information sheet and any remaining Chlorhexidine 4% body wash and Mupirocin 2% nasal ointment into hospital with you.

Please contact us if you have any questions or concerns about using the Chlorhexidine 4% body wash and Mupirocin 2% nasal ointment.

Wrightington Pre-operative Assessment Clinic: 01257 256340