Preparing for Your Surgery: Reducing the Risk of Infection

At NYU Hospital for Joint Diseases we care about you. Follow these instructions to help reduce your risk of infection following surgery.

Use a chlorhexidine gluconate-containing soap, available over the counter (such as Hibiclens or Betasept), to shower for 5 days before surgery.  This soap is available over the counter at many pharmacies, and costs about $10 for an 8 ounce bottle. The soap works by decreasing the number of bacteria on your skin. It’s important to apply the soap correctly and keep it on your skin for longer than normal soap. Here’s how to use it:

1. Get in the shower and get completely wet, then turn the water off.
2. Apply the soap by FROM YOUR CHIN DOWN using a clean washcloth.
3. Do NOT get this soap in your ears or eyes; it can cause damage to hearing.
4. Lather up with the soap, paying special attention to the area of your surgery, and your underarms and groin.
5. Keep the soap on for AT LEAST 2 MINUTES.
6. Rinse off thoroughly after 2 minutes.
7. Because this soap’s effect is greater with more applications, we ask you to do this type of shower for 5 days prior to your surgery.

Patients who are going to have joint replacement surgery or spine surgery will get their nose cultured during pre-admission testing. We give all patients a prescription for mupirocin (Bactroban) nasal ointment. Please get the prescription filled and use the ointment twice a day for 5 days prior to your surgery (start the ointment and special showers on the same day, the last dose of the bactroban should be used on the morning of surgery). This ointment kills Staph aureus, including methicillin resistant Staph aureus (MRSA), and has been found to decrease the risk of a surgical site infection in people who harbor this bacterium in their nose.  Here’s how to use Bactroban:

1. Squeeze approximately one-half of the ointment from the single-use tube into 1 nostril and the other half into the other nostril twice daily (morning and evening) for 5 days.
2. After application, the nostrils should be closed by pressing together and releasing the sides of the nose repetitively for approximately 1 minute. This will spread the ointment onto the skin surfaces in your nose.
3. Discard the tube after usage; it should not be re-used.

At NYU Hospital for Joint Diseases, we encourage you to partner with us to improve your care. Please ask your care providers if they’ve cleaned their hands before they care for you.  It’s hard to remember each and every time we have to clean our hands, but by partnering with you, we can all give and get the best care possible.  Don’t be surprised if we ask you how we’re doing.  Hand hygiene is an important way to prevent the spread of infection, and as an orthopaedic specialty hospital, we are very serious about that. 

If you have questions about this information, please ask your surgeon or any of our staff in the pre-admission testing department.