Nasal Decolonization is Important for Patients Undergoing Major Surgery

People carry bacteria inside the warm, moist environments of the nose. In this location, bacteria can thrive since we do not wash out the insides of our noses. Hair inside the nose also adds to the ability of the bacteria to reside successfully in this location. One type of problematic bacteria is Staphylococcus aureus (MSSA), and its antibiotic resistant strain, Methicillin-resistant Staphylococcus aureus (MRSA).

Bacteria in the nose is difficult to eliminate safely. In the past, the medical community relied on topical antibiotics to eliminate nasal bacteria but this involved pre-screening patients and then pre-surgical treatment several times daily up to one week ahead of a surgery. In addition to the time and effort disadvantages, use of topical antibiotics for prevention of surgical site infections resulted in significantly higher rates of resistance to those antibiotics, in part, due to the low patient compliance rates of less than 35%.

Why is bacterial colonization of the nose an issue to patients about to undergo a major surgery? Patients who are recovering from major surgeries have a compromised immune system. When our immune systems are not up to par, bacteria can become opportunistic. They can sense when the host immune response is weakened and become more aggressive at a time with the patient’s body is much less capable of warding off a bacterial infection. For this reason, people who carry certain bacteria in the nose prior to surgery are more likely that others to succumb to a post operation surgical site infection.

Surgical site infections are infections that occur after surgery in the part of the body (whether on the surface skin area, or in deeper tissue such as organs and muscle) where the surgery was performed. According to the CDC, up to 3% of patients who have a surgery will develop a surgical site infection. In a number of studies, it was demonstrated that eliminating the bacteria in the nose prior to infections has a significant impact, typically cutting the rate of surgical site infections by half.  Non-antibiotic nasal decolonization approaches that do not require patient compliance are therefore of great importance to both the patient and the health care system. Photodisinfection is a non-antibiotic therapy that has been proven to be highly effective at safely eliminating bacteria from the noses of patients and has significantly reduced the rate of surgical site infections in its debut hospital deployment.

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