by Dr. Darshan Shah, MD, FACS
What Is MRSA?
MRSA—short for methicillin-resistant Staphylococcus aureus—is a bacterial “staph” infection dubbed by the media a “superbug” because of its resistance to commonly prescribed antibiotics including methicillin, oxacillin, penicillin, and amoxicillin. According to the Centers for Disease Control and Prevention (CDC), MRSA bacteria is present in only about one percent of the population; and while just carrying the bacteria, termed “colonization,” does not mean an individual will become ill, they can still pass it to others who may develop the more serious, and potentially fatal, surgical wound/skin infections, bloodstream infections, or pneumonia.
What Is Community-Associated MRSA (CA-MRSA) and How Does It Differ from MRSA?
MRSA is most often seen in people in hospitals and healthcare centers who have weakened immune systems. However, in the 1990s, it began appearing in the general public. According to the CDC, “MRSA infections that are acquired by persons who have not been recently (within the past year) hospitalized or had a medical procedure (such as dialysis, surgery, catheters) are know [sic] as CA-MRSA infections.”
MRSA and Cosmetic Procedures
So how does the risk of MRSA and CA-MRSA relate specifically to those considering plastic surgery or cosmetic surgery? The main reason that cosmetic patients need to be concerned about MRSA is that having a fresh incision makes one more susceptible to contracting an infection. And while many safe, clean plastic surgery facilities maintain a sterile environment and might have a low rate of any type of post-op infection, most plastic procedures are outpatient, which means patients return home, and into the community, the same day as their surgeries. Consequently, the responsibility for protecting against infection rests predominantly on the patients themselves.
Dr. Shah’s Tips for Preventing MRSA
So what are the most effective measures patients can take toward prevention? Compiled from materials distributed by the Mayo Clinic and the CDC, Bakersfield plastic surgeon Dr. Shah tailors his tips specifically to protecting patients from MRSA following plastic surgery.
Prior to your procedure:
Prepare your place before surgery. Clean your home thoroughly prior to your surgery by wiping down all surfaces with a cleaning solution that states explicitly on the label that it kills methicillin-resistant Staph aureus, such Mr. Clean Antibacterial Multi-Surface spray or StaphAseptic (www.StaphASeptic.com). This means you’ll return home to safe surroundings and eliminate the need to wipe away (and come into contact with) germs when your incisions are at their most vulnerable.
Sanitize towels and bedding. Wash all linens directly before your procedure, so only clean cloths will be near your fresh incisions. Continue to cleanse towels, bedding, and clothing frequently for a month post op, washing and drying on “hot” (and adding bleach, ideally).
For the first MONTH post op:
Keep hands clean. Wash hands regularly with soap and water, particularly after returning home or touching shared surfaces: Scrub thoroughly for a minimum of 15 seconds, then dry with a non-reusable towel (such as a paper towel), and turn off faucet using a fresh sheet. Of course, remember to always wash your hands before touching your incisions!
Keep incisions clean and covered. Since recent wounds allow easy entry for MRSA and other bacterial infections, the most important protective pointer is to make sure your incision(s) are clean and covered at all times, using simple soap and water; then wrapping with a fresh, dry bandage; and even still, avoiding skin-to-skin contact as much as possible. Remember, moisture creates an ideal environment for bacteria to grow; so keep your incisions as dry as possible.
Pack Purell (and pass it around!) When out and about, carry a bottle of hand sanitizer in case you get caught without the ability to wash. At home, give each family member a bottle of their own, so they can avoid passing potentially dangerous bacteria on to you.
Shun the sharing of personal items. Since MRSA can be spread via contaminated items as well as direct contact, it’s crucial that you not share anything that touches your incisions until they are completely healed, including towels, razors, sheets and blankets, and clothing. Because CA-MRSA is contagious in the community at large, anyone—no matter how hygienic—is a potential carrier…and can potentially pass it along to you!
Keep yourself clean. The cleaner your body in general, the less likely bacteria is to find its way into your wound(s). Therefore, for the month following your surgery, make certain you shower (with soap) regularly, particularly after public outings or exercise.
Avoid breeding-grounds for bacteria. Because certain places—like schools, hospitals, gyms, and jails—are known for being ripe with bacteria (including MRSA), try your best to stay away until you are fully healed. If absolutely unavoidable, make sure your incisions are well bandaged and covered with clothing.
Watch for warning signs of MRSA. Keep an eye on your incision(s), and call your surgeon immediately if you observe an increase in redness, swelling, or tenderness, or if you develop any “oozing,” drainage, or a fever.
What if I Become Infected…Is MRSA Treatable?
Yes; MRSA can be remedied with certain antibiotics or treating/draining the infected abscess or boil itself.
So while MRSA does have the potential to be life threatening, all sources seem to come to the same conclusion: Patients like you play an integral role in staying safe. MRSA is a serious issue, but one that can be controlled by understanding transmission and practicing some relatively simple precautions.