Treatment for MSSA Prior to Joint Replacement Surgery

Why have you been contacted?

This leaflet will help you understand what MSSA is and how it can affect you when having your joint replacement surgery.

You have been found to be colonised with MSSA on a swab taken from your skin at your pre-assessment appointment and have now been provided with decolonisation treatment.

What is MSSA?

Methicillin Sensitive Staphylococcus Aureus (MSSA) is a type of bacteria that can live on the skin. MSSA is harmless unless it has an opportunity to enter the body through a cut in the skin, as it can cause a wound infection.

Is MSSA the same as MRSA?

No, while they are the same type of bacteria, MSSA responds well to antibiotic treatment. MRSA (Methicillin Resistant Staphylococcus Aureus) is resistant to a larger number of antibiotics.

How common is this type of bacteria?

Approximately one in three people in the general population are colonised with MSSA in their nose, throat or on their skin. These people are classed as “carriers”. It is unlikely to cause any harm.

Why do we screen patients for MSSA?

Screening by taking a swab from your nose, throat and groin at your pre-assessment clinic appointment, can identify those that may be colonised with MSSA and provide options to reduce the risk of post-operative wound infections.

After your surgery you will have a surgical wound that can take up to 14 days to heal. If you have MSSA on your skin it may spread into the wound causing a wound infection. Carriage of Staph aureus is a known risk factor for post-operative infection following surgery.

In some types of surgery, such as prosthetic joint replacement, pre-operative screening and de-colonisation as well as antibiotic prophylaxis are used to lower the risk of infection.

How is it spread?

The most common way for MSSA to spread is on hands. Preventing the spread of this type of bacteria is by simple handwashing with soap and water.

MRSA and MSSA do not harm healthy people, including pregnant women and children.

If your swab result is POSITIVE, will your surgery be cancelled?

If you are found to be MSSA positive and have not used the decolonisation treatment, your surgery may be postponed.

If you cannot use the treatment provided for any reason, please let us know prior to your surgery.

If you find your surgery date has changed and you have already started your treatment, you may need to be provided with a further supply of decolonisation treatment to use before your new surgery date. Please contact us.

The decolonisation treatment consists of an antimicrobial body wash, nasal ointment and a mouthwash. Instructions are explained.

Treatment

Use for Five days before and Five days after surgery, this includes the day of your surgery. Instructions for use –

Octenisan Antimicrobial body wash

Given at your pre-assessment appointment with instructions. Please read guide sheet.

Bactroban (Mupirocin 2%) Nasal Ointment

Nasal ointment needs to be applied three times a day.

A small amount of ointment should be placed on a cotton bud or tip of your clean finger and apply to the front part of each nostril. The nostrils should be closed by pressing the sides of the nose together; this will spread the ointment through the nostrils.

Mouthwash and Dental cleanliness

It is important to keep your mouth clean when you have MSSA in your nose as it may also colonise the back of your throat.

Cleaning your teeth after each meal and last thing at night then using a mouthwash containing chlorhexidine, such as Corsodyl, will help to clear your nose and throat of MSSA colonisation. Dentures can be washed in warm soapy water, rinsed, brushed with toothpaste and then rinsed again.

Bring your left over treatment into hospital with you. Treatment continues for five days after your surgery. If you are running low or have forgotten any items please let the nursing staff know.

Contact information

If you need further advice or information contact us –