Advice after your nerve block for surgery
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What is MRSA?
MRSA is the abbreviation for Meticillin-Resistant Staphylococcus aureus. It is a variety of common skin bacteria, which has become resistant to some of the more commonly used antibiotics.
In healthy people, the bacteria usually lives harmlessly on the skin. It can be carried for a short time (transient carriage) on skin or in the nose, or may be part of a person’s skin flora (colonisation).
People both in hospital and in the community can be colonised with MRSA (approximately 2-3% of the population), and there is not always a clear reason for this.
Who is at risk from MRSA?
When MRSA has the opportunity to enter the body, it may cause infections or slow down healing and recovery. Most at risk are those having major surgery (vascular or implant surgery) and those who are very unwell and have poor immune systems.
What is MRSA Suppression Therapy?
‘MRSA suppression’ is the term used to describe the treatment used to reduce the number of MRSA bacteria living on the skin. The treatment is prescribed for patients who have had a MRSA-positive screen or specimen on admission to hospital, or prior to admission when they are booked for an elective admission.
MRSA suppression therapy consists of using a prescribed body wash for 5 days, and a topical antibiotic cream, which is applied to the inner surface of your nose.
Why do I need treatment?
MRSA suppression therapy may not remove all the bacteria living on the skin, but what it will do is reduce the amount of MRSA on your skin, which in turn may reduce the risk of infection from MRSA when you are in hospital.
If I am colonised with MRSA does that mean I will not be admitted to hospital?
Being colonised with MRSA should not delay your admission to hospital.
The fact that the medical and nursing staff know that you are colonised with MRSA means that they can take appropriate measures to protect you, and help prevent the bacteria being spread to other patients.
Ideally the treatment should be started 5 days before you are admitted to hospital, to ensure maximum reduction in MRSA prior to your planned operation/ treatment. (Day 5 = planned date of admission/surgery) If there is not enough time to complete the full course of suppression therapy before you enter hospital, it is better for treatment to be started than having none at all.
How do I use the nasal cream and body wash?
Octenisan Body Wash
Approximately 25 mL is used instead of soap to wash the body every day for 5 days. Do not put it in water like bubble bath. On days 2 and 4 of treatment the hair should also be washed with the body wash.
Use a clean flannel each time, and dry yourself off with a clean towel.
Your body naturally sheds small skin scales on which the MRSA bacteria will still be found. These remain on your flannel, towel, and clothing. To reduce the likelihood of you recolonising yourself with MRSA you should always put on a clean set of clothing after bathing or showering.
Change the sheets on your bed on days one and four.
Approximately 10 mL is used instead of shampoo to wash your hair. Ensure you pay attention around the hair line and behind the ears.
If the skin cleanser causes skin irritation stop using it and contact the preadmission clinic that supplied the prescription for advice.
Mupirocin nasal ointment 2%
Mupirocin nasal ointment is applied inside both nostrils three times a day for 5 days.
Apply to each nostril using a clean finger, and rub the outside of your nose until you can taste the ointment. Do not poke the tube of ointment up your nose, as this will contaminate the tube. Wash your hands after application.
If samples taken show that MRSA is not likely to respond to mupirocin, or you are allergic to mupirocin ointment you will be provided with Naseptin™ cream instead.
Naspetin™ (Chlorhexidine 0.1% and neomycin 0.5%)
NOT SUITABLE IN PATIENTS WITH NUT ALLLERGIES AS IT CONTAINS PEANUT OIL
Naseptin™ cream is applied inside both nostrils four times a day for 5 days.
It is applied in the same way as the mupirocin nasal ointment.
Use the pull out sheet in the centre of the booklet to help you to record your treatment before your surgery.
Contact us
If you have any queries relating to this information, please contact the Infection prevention and control (IPC) service.
About this information
Service:
Infection prevention and control (IPC)
Reference:
LL/015
Approval date:
25 June 2026
Review date:
1 June 2028
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.