Planned orthopaedic patients at Dartford and Gravesham NHS Trust will get a five-minute nasal light treatment before surgery. It replaces days of nose cream at home.

Patients having planned orthopaedic surgery at Dartford and Gravesham NHS Trust are to be treated with a five-minute light therapy in the nose just before their operation. The aim is to cut infections after surgery.

The trust runs Darent Valley Hospital. The treatment is called Steriwave. Its maker, Ondine Biomedical, announced the deal in a stock exchange statement on 5 November. Ondine sells it in the UK through Mölnlycke Health Care.

How the treatment works

Bacteria that live in the nose, including MRSA, are a known source of infections in surgical wounds. Hospitals usually tackle this with an antibiotic nose cream that patients apply at home for several days before an operation.

Steriwave works differently. According to Ondine’s statement:

  • a clinician applies a light-activated antimicrobial agent inside the nose
  • a red light is then used to activate it, reducing the bacteria
  • the whole treatment takes about five minutes
  • it is given immediately before surgery, at the hospital
  • it does not use an antibiotic

Why the trust wanted it

The trust tried Steriwave first. Will Ferreira, deputy director of operations for the trust’s surgical, critical and planned care division, said the trial tackled “a longstanding planning challenge around MRSA screening and decolonisation before elective surgery”.

That problem shows up when a patient needs to be fitted into a surgical list at short notice. There is no time for days of nose cream.

“Through the Steriwave trial, we have so far been able to treat patients within this cohort at our QMH site, with treatment organised in less than 24 hours,” he said. QMH is Queen Mary’s Hospital in Sidcup, in the London Borough of Bexley, where the trust also runs planned surgery.

He said this had “helped us make better use of available theatre time, which might otherwise have gone unused”.

Kris Khambhaita, the trust’s director of infection prevention and control, said preventing avoidable infections was “a key priority”, and called the treatment “an innovative addition to our wider infection prevention approach”.

What the figures say, and what they do not

The statement gives no figures from the trust’s own trial. The results it quotes come from other hospitals:

Trust Surgery Reported fall in surgical site infections
Leeds Teaching Hospitals High-risk skull base surgery through the nose 78%
Mid Yorkshire Teaching Planned hip and knee replacements 71%

Both figures are as reported by Ondine. The statement also cites the York Health Economics Consortium, which it says found the treatment saves money.

It quotes the NHS Getting It Right First Time programme, which found that hip and knee patients who get a surgical site infection need an extra two to four weeks of inpatient care.

NHS Supply Chain has classed Steriwave as an “Innovation Product”, which makes it easier for other NHS trusts to buy.

The statement does not say when the treatment starts at Darent Valley Hospital itself, how many patients will receive it, or what it costs the trust.

What it means for you

  • If you are waiting for a planned hip, knee or other orthopaedic operation with the trust, you may be offered the nasal light treatment on the day instead of a course of nose cream at home. Your pre-operative assessment team can tell you which applies to you.
  • If you are called in at short notice for an operation, this is the group the trust says has benefited most so far.
  • Keep following the instructions you have been given. Nothing in the announcement changes existing pre-op advice until the hospital tells you so.

The trust’s ICU is also expanding: read our report on Darent Valley Hospital’s plans to grow intensive care from 10 to 15 beds.