Randomized Controlled Trial of Preoperative Topical Decolonization to Reduce Surgical Site Infection for Staphylococcus aureus Nasal Swab-Negative Mohs Micrographic Surgery Patients

Dermatol Surg. 2019 Feb;45(2):229-233. doi: 10.1097/DSS.0000000000001662.

Abstract

Background: Surgical site infection (SSI) is mainly due to endogenous bacteria. Topical decolonization is a preoperative intervention currently advised for proven nasal carriers of Staphylococcus aureus (S. aureus).

Objective: The authors assessed whether topical decolonization could be of benefit for patients who are not nasal carriers of S. aureus.

Methods and materials: The authors performed a randomized controlled trial of S. aureus nasal swab-negative patients. Five days before Mohs surgery topical decolonization with nasal mupirocin and chlorhexidine, body wash was started. The control group had no intervention.

Results: In the week after Mohs surgery, the infection rate in the intervention group was 2% (n = 661, 14) and that of the control group was 4% (n = 689, 29).

Conclusion: Topical decolonization reduces SSI in nasal swab-negative Mohs surgery patients.

Publication types

  • Review

MeSH terms

  • Administration, Intranasal
  • Administration, Topical
  • Aged
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Infective Agents / administration & dosage*
  • Antibiotic Prophylaxis*
  • Carrier State / drug therapy
  • Carrier State / microbiology
  • Chlorhexidine / administration & dosage*
  • Decontamination / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mohs Surgery*
  • Mupirocin / administration & dosage*
  • Nose / microbiology*
  • Preoperative Care
  • Skin Neoplasms / surgery*
  • Staphylococcus aureus / isolation & purification
  • Surgical Wound Infection / microbiology
  • Surgical Wound Infection / prevention & control*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Mupirocin
  • Chlorhexidine