You have been given this leaflet as you are undergoing surgery at the RNOH. One-third of healthy adults carry normal bacteria called Staphylococcus aureus in their nose and skin. Whilst you are healthy and not undergoing surgery, the risk from these bacteria is rare. The aim of decolonisation is to remove Staphylococcus aureus from your skin, so there is less opportunity for it to cause an infection related to the surgery. Please note that if you decide not to use the Staphylococcus aureus decolonisation therapy, you are at an increased risk of infection.
The decolonisation treatment for Staphylococcus aureus includes a nasal ointment to start five days before surgery and Chlorhexidine washcloths for two days before surgery:
• One tube of Bactroban Nasal Ointment (Mupirocin 2%)
• Two packs of Chlorhexidine washcloths (8 cloths in each pack)
If your operation is cancelled, then you will need another course of Staphylococcus aureus decolonisation prior to your next operation date. Staff will discuss this with you prior to readmission.
You will be given additional antibacterial body wipes during your stay to complete the full course. Please remember to take your antibiotic nasal ointment or cream with you to the hospital for your admission. If your operation is cancelled, you will need another course of Staphylococcus aureus decolonisation prior to your next operation date. Staff will discuss this with you before your operation.
There are two different antibiotic nasal products available. You will only need to use one of these products. The product you will be supplied depends on whether you are allergic to any of the ingredients. Your nurse or pharmacist will ensure you are supplied with the best product for you. The next section will provide more details on how to use the products.
Check you are not allergic to any of the ingredients before use
How to use:
• Start 5 days before surgery, including the morning on the day of the operation.
• Apply a match-head-sized amount of nasal ointment inside each nostril three times a day.
• Then, press the sides of the nose to help spread the ointment.
√ Tick the box each time you use the treatment
Check you are not allergic to any of the ingredients before use. Do not use this product if you are allergic to peanuts or soya or chlorhexidine or neomycin
How to use:
• Start 10 days before surgery, including the morning on the day of the operation.
• Apply a match-head-sized amount of nasal cream inside each nostril four times a day.
• Then, press the sides of the nose to help spread the ointment.
√ Tick the box each time you use the treatment
Check you are not allergic to any of the ingredients before use.
How to use:
• Start 2 days before surgery, including the morning on the day of the operation.
• Apply daily directly to the skin (topically).
√ Tick the box each time you use the treatment
If you have been supplied with wash gloves instead of wipes, please follow instructions on the back of the pack.
Body areas to cover (please use one new wipe per step)
Days 1 and 2: TWO days before your surgery
Routine shaving should be stopped at least two days before your surgery on all areas of your body, including the legs and underarms. This is to prevent any skin irritation which could lead to an infection. Continue to wash/shower or bathe with your regular products at home. You can continue to shave your face and neck.
Your skin needs to be prepared using the Chlorhexidine washcloths once a day as explained below. You may need somebody to help you to ensure that all body areas are covered.
Do not allow this product to come into contact with your eyes, ears, or mouth.
Occasionally the Chlorhexidine cloths may cause skin irritation such as a temporary itching sensation and/or redness. Showering or shaving immediately before applying may increase this effect.
Day 3: Day of your surgery
Prior to coming to the hospital, have a bath or shower as normal. Further supplies of antibacterial body wipes will be available on the ward for the day of operation.
Patients with 2 planned operations during the same hospital stay
Clinical staff will provide a second pack of decolonisation products to begin using prior to your 2nd operation. If there is insufficient time between operations to complete 5 full days of nasal decolonisation, then continue after the 2nd operation to complete the course.
Hopefully, this leaflet has helped answer all your questions. If you still have any concerns such as skin issues, please contact the Pre-operative Assessment Department.
Alternatively, you can contact the Infection Prevention and Control Team between 8 am to 4 pm Monday to Friday.
For out-of-hours queries, please leave a message with contact information and someone will get back to you as soon as possible.
Pre-operative Assessment Department: 0208 909 5630
Infection Prevention and Control Team: 0208 909 5625
Email: rnoh.infectioncontroldept@nhs.net
C25-01 (Rev 22-180) © RNOH
Date of publication: December 2024
Date of next review: December 2026
Author: Specialist Antimicrobial Pharmacist & Infection Control
Page last updated: 13 May 2025