Hair removal is commonly performed before any surgery to provide the surgeon with a clean field and to prevent hair from falling into the surgical site. Many reports have however indicated an increased risk for surgical site infections in patients undergoing preoperative hair removal.
Scanning electron micrographs show that razors cause gross skin cuts while clippers cause less injury, and depilatory agents cause no injury to the skin surface. The rates of surgical site infections are higher when shaving is performed (6%) compared with clipping (1.7%) the hair or use of depilatory creams (0.6%).
The lowest rates of surgical site infections are reported when hair is removed just prior to the surgical incision.
Neurosurgeons question the need for hair shaving in brain surgery. Those who do not remove the hair follow the following
1. Patients have their hair washed with shampoo and 4 % chlorhexidine within 24 hours of their operation.
2. In the operating room, the surgical site is scrubbed for 8 to 10 minutes with 4 % chlorhexidine diluted with water, and then cleansed with 10 % povidone-iodine solution.
3. Prophylactic antibiotics are administered for three days.
The current view is that there is no difference in rate of surgical site infections among patients who have their hair removed prior to surgery and those who have not. If hair needs to be removed, it should be clipped rather than shaved, as patients who are shaved are more likely to develop surgical site infections.
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