Intranasal white petrolatum versus chlorhexidine to reduce postoperative infections in dermatologic surgery

Referrals to the Skin Centre for excision of skin cancers will be selected for possible inclusion by one of five participating Consultant Dermatologists. Eligible and consenting patients will at the time of consultation for surgery, fill in a short questionnaire for demographic data and have a nasal swab to assess staphylococcus aureus carriage. The patients will be randomised to either intranasal white petrolatum, 2% chlorhexidine or normal saline to the anterior nares. Five days prior to elective surgery, all patients will apply one of three treatments (depending on randomisation) to the anterior nares twice daily. In the chlorhexidine arm and the normal saline arm, this will be in the manner of a soaked cotton bud whereas in the white petrolatum arm, this will be in the manner of a cotton bud application. All patients will have their wound assessed at the time of suture removal (expected range: 5 – 14 days depending on type of surgery) or if any clinical signs of wound infection occur outside this time frame (up to one month post-surgery). All infected wounds will be swabbed. The incidence of wound infection will be collected and a comparison will be made to the incidence of wound infection in patients being treated with intranasal white petrolatum, 2% chlorhexidine and individuals using intranasal normal saline.