A hospital-acquired infection (HAI) is the dreaded result of a patient who did not have an infection upon admission to a hospital but developed one during their stay. It’s estimated that 1 in 31 hospital patients develop an HAI, affecting two million patients annually and accounting for over 100,000 deaths in the United States alone.

Dr. John Polley, MD, a cosmetic, plastic, and reconstructive surgery specialist who currently practices in Bozeman, Montana, has been on the front lines fighting infection for over four decades. He has been extensively involved in research and teaching throughout his career, has developed multiple medical devices and holds several US patents on medically related items.

Dr. Polley has published over 135 peer-reviewed articles in scientific journals, lectured and operated throughout the world, and volunteered on over a dozen surgical mission trips, mostly in Central America. He has received numerous accolades, including “Top Doctor” in Chicago Magazine over the past decade, as well as many other regional and national awards.

We recently had an opportunity to sit down with Dr. Polley, who chatted with us about his substantial contributions to infection prevention, including the development of SaniiSwab, a two-step nasal decolonization system that can help reduce HAIs.

Responses have been edited for clarity and conciseness.

Tell us a little bit about your background and areas of expertise.

I’m a plastic surgeon by training, specializing in various reconstructive and cosmetic procedures. I worked for 25 years in Chicago, 10 years at the craniofacial center at the University of Illinois and 15 years as the Department Chairman of Plastic Surgery at Rush University, while simultaneously working at Cook County Hospital. My main focus was on head and neck and maxillofacial surgery, facial aesthetic surgery, congenital facial anomalies, and traumatic facial injuries. 

In 2014, with our kids out of the house, my wife and I decided to move to Traverse City, Michigan where we had vacationed for years with our family and dreamed of one day relocating to. In Michigan I worked in both Traverse City and Grand Rapids. My practice has always been about 75 percent facial surgery, with the remaining portion dedicated to traditional plastic surgery. Most recently I have joined the outstanding group at Gallatin Valley Surgical Arts in Bozeman, Montana.

How does SaniiSwab Nasal decolonization work, and what makes it effective?

SaniiSwab is an efficient way to clean and sanitize your nose. Non-medically, you’d say you’re cleaning your nose, but in the medical field, we call it nasal decolonization to eliminate bacteria.

I’ve been doing nasal decolonization throughout my career because when you’re working on the face, you must also clean the nose. When we speak of cleaning the nose we mean not only the outer skin of the nose that we can see but also the skin of the nasal vestibule. The nasal vestibule is the inside part of our nose that extends upwards about one and a half inches inside the nose from the nostril rim. This is the part of the nose people pick and pull hairs from! The nasal vestibule is lined with skin, not nasal mucosa.

The nasal vestibule has hair follicles, mucous glands, sweat glands, and it desquamates or sheds just like the rest of the skin of our body. This process continually happens, so the nasal vestibular skin or lower half of the inside of your nose, just like the rest of your body’s skin, needs to be cleaned regularly.

When I prep and drape a patient, I perform this process myself. I’ve always had great success; in my 34 years of practice, I’ve never had a surgical infection. This is due to two reasons: I always do my own prep, and I use a two-step prep technique, which involves cleaning and disinfecting a patient using one product and then repeating this procedure with a second sanitizing agent.

SaniiSwab mimics this process in a simple, easy, portable product that you can take with you. It’s not just the soap and alcohol in it; it’s also the mechanical cleaning that makes it effective.

What inspired you to develop SaniiSwab? Was there a specific moment or need you identified that led to its creation?

It all started during the COVID-19 pandemic. I was working in Grand Rapids, and we had a lot of COVID cases in Southern Michigan. Elective surgeries were shut down, but many necessary surgeries still had to take place.

I was exposed to COVID daily and being in my 60s, I knew I had to take extra precautions in addition to the standard PPEs. Most viral and bacterial infections are breathed in, get stuck in the nose, incubate, and then infect the patient.

So, I applied the same two-step, dual-prep sanitizing process I use for surgery on myself with great success. I then realized this would be great to offer to all patients. I invented the double swab, which has now been patented, to simplify the process and assure people wouldn’t place a swab too far into the nose, but keep it right where we needed it.

How does SaniiSwab compare to the competition?

The SaniiSwab concept isn’t new, it’s adhering strictly to operative prep protocol. SaniiSwab translates what we do in the operating room, for everyone to use for routine daily nasal hygiene. SaniiSwab employs a two-step procedure with mechanical cleaning and applies two different cleaning or sanitizing agents in each step. This methodology, amongst other attributes, is a distinguishing factor of SaniiSwab compared to other nasal decolonization products.

SaniiSwab was developed by a surgeon who has spent a career cleaning noses the proper way!

Can you share some feedback or testimonials from healthcare providers or patients who have used SaniiSwab?

We’ve seen remarkable results in a published clinical study. Preoperative patients whose noses tested positive for harboring the bacteria Staphylococcus aureus, tested negative with the same test after cleaning their noses with SaniiSwab twice a day for a week. This is important because Staphylococcus aureus is routinely found in about one third of the general population and is the bacteria that most commonly causes postoperative infections.

Regarding allergies, many of our friends and patients with seasonal and traditional allergies have experienced significant improvement. Plant pollen often gets caught in the front of the nose, with proper nasal cleaning and decreasing the dander load, there are fewer allergens to irritate the posterior sinuses and trigger the inflammatory process of allergies. While we don’t have large numbers on this yet, the feedback has been extremely positive.

I understand that SaniiSwab nasal decolonization does not require healthcare workers to administer it. Why is this so important in today’s healthcare setting?

With the current product, that is true. SaniiSwab can and should be self-administered. We have a member of the nursing staff show the patient how to use it initially. After that, the patient should clean their own nose, making the patient responsible for an important aspect of their own health care.

One thing we’re seeing on the hospital side is that when patients clean their own noses with SaniiSwab, it decreases the workload on the nursing staff. If you multiply that work by all the patients who need nasal hygiene (which should be all patients), it can save each nurse up to an hour or more every day.

How does SaniiSwab align with the broader goals of infection control and prevention in the healthcare industry?

The importance of nasal decolonization is becoming well-recognized. Numerous studies have shown that pre-surgical nasal decolonization decreases postoperative infections in all areas of surgery. There is no disputing that.

From a surgical perspective, using nasal decolonization before and after surgery is an important treatment for infection prevention. The same applies to ICU care. These patients rarely, if ever, have their noses cleaned, leaving them full of crusted debris. Universal nasal cleaning for all patients should be the goal.

Bacteria and viruses thrive in dark, warm, and moist environments. The nose is the perfect spot for germ colonization. The nose is our body’s air filter, which filters airborne contaminants from the air we breathe in. Just like your furnace filter or car air filter, our nose or nasal air filter needs routine maintenance to function efficiently.

If we think human hygiene is important, we must recognize the importance of nasal hygiene. Everyone knows that daily hand hygiene is important, but nasal hygiene is equally, if not more, important for all the reasons discussed. We have all been taught how to wash our hands since kindergarten. But who taught you how to clean your nose? Probably no one — until now! SaniiSwab is the proper way to clean your nose, which is vital to good health.