Onychomycosis in the OR

[NJPAIN]

Gentleman:

Forgive me, a non-podiatrist for invading your forum; however, I have an issue that perhaps you can help me with. I am a practicing pain management physician(anesthesiologist). I have a 30 something year old healthy patient who was scheduled for an epidural steroid injection tomorrow. On the preoperative phone call earlier today she disclosed that she was placed on Lamisil in the last few days for "foot fungus". The nurse administrator cancelled this case because the case to follow this case was an open spine case and it presented an "infection control issue". In my 25 years as an anesthesiologist/pain physician this is a first for me. As physicians who deal with these types of infections does this make sense to you?

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[darazon]

Doesn't make sense to me, but my experience is very limited.

I have scrubbed total joint cases with ortho where a lot of the patients had fungus.

 

[PADPM]

Gentleman:

Forgive me, a non-podiatrist for invading your forum; however, I have an issue that perhaps you can help me with. I am a practicing pain management physician(anesthesiologist). I have a 30 something year old healthy patient who was scheduled for an epidural steroid injection tomorrow. On the preoperative phone call earlier today she disclosed that she was placed on Lamisil in the last few days for "foot fungus". The nurse administrator cancelled this case because the case to follow this case was an open spine case and it presented an "infection control issue". In my 25 years as an anesthesiologist/pain physician this is a first for me. As physicians who deal with these types of infections does this make sense to you?

If the patient has a full blown fungal infection of the skin, I could possibly understand the case being postponed. But if the patient is simply being treated for onychomycosis, I have never heard of a case being canceled. I do major bone surgery on the foot and ankle which is in very close proximity to fungal nails occasionally, and it has never been an issue.

If the nurse is still overly cautious, simply put a pair of surgical booties over the foot or sterile stockinette. I doubt if the "cooties" will escape !