Tummy Tuck - MRSA. How can I ensure that I do not develop an infection?

Question

I am very seriously considering a tummy tuck, but am very nervous about the healing process after a major surgery. I have a history of MRSA skin infections - mostly boils that have subsided after topical and/or oral antibiotics, but I have had a few recurrent infections over the last 4-5 years. Besides the usual practices of maintaining good hygiene and keeping the area clean, is there anything else I can do to ensure that I do not develop an infection?

Irena Karanetz, MD · Answer

Hi, Thank you for the question. 
There are specific protocols prior to surgery for patients with history of MRSA infection. 
Typically, patient is tested for presence of active MRSA infection using nasal swab cultures. Next, patient is treated with mupirocin ointment (topical antibiotic) to the nares twice daily and chlorhexidine (antimicrobial) bath once daily for 5 days before surgery. This effectively can minimize the risk of infection. 
I would recommend an in person evaluation by the plastic surgeon to further evaluate the thickness of your skin and status of your muscles, as well as evaluation of the umbilical hernia by the general surgeon for possible simultaneous repair. 
I hope this helps.Best regards, Dr. Karanetz
Dr. Irena KaranetzFellowship-TrainedBoard Certified Plastic Surgeon

Michelle Zweifler, MD · Answer

Overall, tummy tucks have a small risk of infection.  Prior to abdominoplasty and a history of MRSA, one should see an infectious disease specialist.  Nasal swabbing for MRSA and possible prophylactic nasal medication.  Cleaning the abdomen preop and postop as per one's plastic surgeon.  Postoperatively, patients need to use their own soap and towels to minimize any contamination.

Homayoun Sasson, MD, FACS · Answer

Thank you for your question, you are correct in being concern about any infection after surgery, particularly if you have a history of previous MRSA infections. MRSA can be colonized in your nasal cavity, I would suggest getting an evaluation by an Infectious disease specialist to evaluate your recurrent MRSA infections prior to having an elective procedure, With the proper treatment and precautions the risk of a serious post- operative infection is significantly reduced. Consult with a board certified Plastic Surgeon to work with you to get the results you desire .Good Luck H. Sasson, MD

Nelson Castillo, MD · Answer

Thank you for sharing your question. You can seek out ways to clear your MRSA colonization and your surgeon may be able to assist with this.  They will also be following strict sterile technique and will likely use an antibiotic before surgery that would cover you against MRSA.  Hope this helps.

Daniel Barrett, MD · Answer

Dear nyc_8390,
it is hard to tell for sure without an examination. Every plastic surgeon has his own preoperative protocol which he recommends to his patients. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

I encourage you to work closely with your surgeon on prophylactic interventions to lower your risk of developing an MRSA infection.  Your surgeon may encourage you to do nasal swabs with medication and to cleanse the skin with special soap the days leading up to surgery.  This is in addition to standard precautions such as keeping the skin clean, using clean towels, etc.

Robert L. Kraft, MD, FACS · Answer

Thank you for your question.  I have seen a connection between MRSA contamination and acrylic nails so, if you do have wraps or acrylics, I would recommend that you remove them pre-operatively.

Mats Hagstrom, MD (license on probation) · Answer

Infections are you really unusual with tummy tucks. The primary reason for this is when drains are placed there is a place for fluid that’s potentially contaminated to leave the body. Most plastic surgeons also give prophylactic anabiotic‘s. In your case they may choose antibiotics that cover MRSA. When things go wrong with a tummy tuck it’s usually more related to wound healing problems from ischemia rather than infections. Obviously infections can happen at any time including spontaneously as you are aware of.

Best,

Mats Hagstrom MD

Best,

Mats Hagstrom MD

Tummy Tuck - MRSA. How can I ensure that I do not develop an infection?

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