Pre-operative Information: Preventing Infection
Most patients do well after spine surgery. However, a small number of patients (about 1 to 2.5 in 100) may develop an infection after the operation. An infection in your spine may cause you to need antibiotics, more surgery, and increase the time it takes for you to recover. All humans carry bacteria on their skin, in their hair, and in their nose, mouth, and stomachs. The normal bacteria that we carry can cause infection after surgery. One bacteria is called Staphylococcus Aureus. To decrease your risk of infection after spine surgery, it is important to find out if you carry this bacteria in your nose.
Testing for Staphylococcus Aureus
About one in four to five people carry Staphylococcus Aureus in their nose where it usually does not cause a problem. Prior to your surgery, your doctor will order a test to check for two types of Staphylococcus Aureus: methicillin resistant Staphylococcus Aureus (MRSA) and methicillin sensitive Staphylococcus Aureus (MSSA). This test will be done at the time of your pre-operative joint replacement class at Rush-Copley. A cotton swab will be gently rubbed on the inside of your nose. It may tickle, but will not hurt. You do not need to fast for this test. You will find out the results before you leave the class.
If you are positive for MRSA or MSSA in your nose, you will be given a prescription for a medication called Bactroban or Mupirocin to use for five days right before your surgery. This medicine will kill the Staphylococcus Aureus. It will come in one large tube or five small packets. You will put this medication on the inside of your nose as directed.
A positive test does not mean you have an infection, only that you tested positive for carrying this bacteria. Your surgery will not be cancelled if you use the medication and body wash as directed.
Another way to decrease infection is to bathe with a special soap prior to surgery. ALL spine surgery patients will receive instructions and packets of a special anti-bacterial soap when you attend your pre-operative class at Rush-Copley. This soap needs to be used whether you tested positive or negative for Staphylococcus Aureus. You will be told to shower with this soap for the three days right before your surgery.