Information for patients about Orthopaedic Surgical Prophylaxis

4% Chlorhexidine Pre Operative Body Wash & 2% Mupirocin Nasal Ointment

Taking a pre operative wash with antiseptic soap and applying antibiotic nasal ointment can reduce the risk of a surgical site infection.

It is recommended you commence the application of the body wash and the Mupirocin Nasal ointment five days before your operation.

Please read carefully and follow the instructions

4% Chlorhexidine Body Wash

You have been provided with this wash to thoroughly cleanse and disinfect your skin prior to your operation.

Chlorhexidine Pre-Op wash helps to reduce the micro organisms which live on healthy skin.

Commence bathing with the body wash:

1. Five days before your operation.
2. Bath daily with the wash, including a body wash on the morning of the day of your operation.

How to Wash

Use a clean (new) sponge or wash cloth to assist you in washing your WHOLE body thoroughly.  Follow these instructions.

1. Wet face, whole body and hair in the shower or bath.
2. Apply a small amount of pre op wash to wet hair.  Lather well and rinse.
3. Apply a small amount of pre op wash and lather your face, around the nasal area.  Shut eyes and mouth tightly to avoid contact with the eyes, mouth and ears.  If accidental contact occurs rinse off immediately.  Rinse with water.
4. Apply pre op wash to cloth and work foam down over the neck, arms and trunk.  Pay particular attention to underarms and into the naval area.
5. Now apply foaming wash cloth to genital, buttock and anal areas.  Men; pay attention to penis and beneath the scrotum.  Women; pay special attention to the skin folds of the vulva.
6. Continue applying the wash down over thighs and legs to your feet.
7. Leave wash for 2 minutes and then rinse off.
8. Repeat this process a second time, once again waiting two minutes before rinsing off with water.
9. Do not apply any lotion, deodorant or powder after the antiseptic shower.
10. Dry yourself thoroughly using a clean towel and dress in freshly laundered clothing.

Repeat this body wash process on the morning of your operation before you come to the hospital.

2% Mupirocin (Bactoban) Nasal Ointment

Using 2% Mupirocin nasal ointment is recommended for a total of 5 days.

Start using the Mupirocin ointment five days before the operation.

How to apply:

1. Apply a ‘double match head’ amount into each nostril using either your little finger or a cotton bud.
2. Massage the sides of your nostril together so that the ointment is spread within your nose.
3. Include an application of the ointment in the morning on the day of your operation.
4. Discontinue use if burning, irritation or soreness is experienced.

Acknowledgements
Edmiston C.E.,Jr et al. Evidence for Using Chlorhexidine
Gluconate Preoperative Cleansing to Reduce the Risk of |Surgical Site Infection.  ACORN Journal 2010; Vol 92: No 5 509-518.

Manufacturer’s Guidance – Orion Laboratories: Chlorhexidine Pre-op Wash, cited May 2010.

Royal Perth Hospital, Pre-Operative Assessment Clinic (POAC): Protocol for reducing surgical site infection in elective prosthetic large joint replacement.

Shenton Park Campus, Pre-Operative Instruction: Mupirocin Ointment and use of 4% Chlorhexidine Body Wash.