Why Clean an NFL Player’s Nose Before Leg Surgery?

Injuries are unfortunately quite common in football, but even among the dozens of weekly NFL injury reports, this one stands out. Washington Redskin quarterback Alex Smith suffered a gruesome spiral leg fracture on November 18, but it was the subsequent infection to that injury that most threatened his career. His story puts a human face on the battle against wound infection, and the simple measures –like nose decolonization – clinicians take every day to reduce the risk of infection during surgery and recovery.

While the exact nature of Smith’s infection is not known, it highlights the risk of surgical-site infections (SSIs). Before entering surgery, clinicians often undertake what is known as decolonization, the process of removing pathogens from the patient’s body. It might be counterintuitive to clean a patient’s nose before leg surgery, but Rosie D. Lyles, M.D., director of clinical affairs at Medline, explains why nasal decolonization is so critical.

“A full 1/3 of population is colonized in the nose with Staphylococcus aureus, the #1 bacteria that causes SSIs. On top of that, the majority (80%) of S. aureus infections are caused by the patient’s own nasal flora,” says Dr. Lyles. “Decolonizing the nostrils with an effective and safe antiseptic like povidone-iodine (PVP-I) instead of an intranasal antibiotic (traditional treatment) can be extremely effective by reducing the bacteria ahead of a surgery like what Smith underwent. More importantly, by using an antiseptic (PVP-I) as an alternative to an intranasal antibiotic, we’re not adding to rise of multi-drug resistance organisms (MDROs) in the public health community.”

Thankfully Smith appears to be on his way to recovery, but his story illustrates the threat that infection poses, and how clinicians and administrators are continually improving strategies to prevent them.

Learn more about how Medline helps health systems prevent infections.