Skin preparation before shoulder surgery
Preparing the skin before an operation is one of the measures used to reduce the risk of infection during shoulder surgery. Dr Cutbush recommends using benzoyl peroxide before the operation as part of that preparation.
Why the shoulder needs particular attention
Cutibacterium acnes is a bacterium that lives within the hair follicles of the skin. It is recognised as being more prevalent on the skin around the shoulder than around other joints such as the hip or the knee, which is one of the reasons shoulder surgery has its own skin preparation routine.
Because the organism sits within the follicles rather than on the skin surface, ordinary surface cleaning in theatre does not fully remove it. Left untreated, it can increase the risk of infection after surgery.
What benzoyl peroxide does
Benzoyl peroxide reduces the numbers of these bacteria on and within the skin. It is widely available, inexpensive, and is the same preparation used in the treatment of acne, which is why it can be obtained without difficulty from a pharmacy.
The protocol
The routine Dr Cutbush recommends is:
- Obtain 5% benzoyl peroxide cream or gel from a pharmacy.
- Apply it twice daily for the two days before surgery.
- Apply it once more on the morning of surgery.
That comes to five applications in total. Apply it to the skin over the shoulder and the surrounding area as directed.
Benzoyl peroxide can bleach fabric, so it is worth using an old towel and old bedding while you are applying it. It can also cause skin dryness or irritation in some people; if the skin becomes significantly irritated, let the rooms know rather than simply continuing.
A straightforward step
This is a simple measure that contributes to the overall approach to reducing infection risk. It is one part of a wider protocol rather than a measure that works on its own, and it sits alongside the preparation carried out in theatre on the day.
Watch the discussion
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Related information
We have written more broadly about preventing infection in shoulder replacement surgery. See also our post on preparing for joint replacement surgery, the surgery FAQs, and the consultation page.