Indications for preoperative screening for Staphylococcus aureus (MSSA or MRSA) nasal carriage and preoperative staphylococcal load reduction (HNE LHD):

• Open cardiac and valve procedures
• Shoulder, hip or knee joint total arthroplasties: primary or revision procedures
• Aortic work (stent and open) and all lower limb open surgery for vascular reconstructions (bypass, endarterectomy). Iliac stents (as they are a covered stent)
• Haemodialysis catheter insertions

Actions 

• Screen for MSSA or MRSA carriage with a single nose swab culture (repeat if surgery delayed > 1 month)
• Carriers of MSSA or MRSA have staphylococcal load reduction performed in the week prior to surgery

Information sheets (HNE Health)

• Pre_Procedure_staphylococcal_load_reduction_-_Information_for_clinicans_V2 IPS-003-FACT-1.2
• Pre_Procedure_Staph._load_reduction_before_a_procedure_Patient_Information_V2 IPS-036-FACT-1.5

Surgical antibiotic prophylaxis recommendations

• See:  HNELHD CG 20_59 Surgical Antibiotic Prophylaxis

Reference

•  PD2017_013_PCP_33_Pre_Operative_Procedures_for_the_prevention_of_surgical_site_infections