Does preoperative scalp shaving result in fewer postoperative wound infections when compared with no scalp shaving? A systematic review. 2012

Sherly Sebastian
Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA. sherlysebastian@sbcglobal.net

Preoperative scalp shaving has been a well-established practice among neurosurgeons based on the belief that hair removal prevents postoperative infections. Apart from aiding in improved visualization of the incision line, ease of closure, and dressing application, there are concerns that the presence of hair at the surgical site may interfere with the surgical procedure. Preoperative scalp shaving is a controversial practice, and many neurosurgeons are moving toward not removing any hair or clipping minimal hair along the incision line rather than shaving the scalp. The following is a systematic review of articles related to preoperative scalp shaving before cranial surgeries and the implications for postoperative wound infections. Eighteen articles were identified as potentially relevant based on the search criteria. These articles were selected based on the inclusion and exclusion criteria to provide concise background information and an explanation of scalp-shaving practices in neurosurgery leading to the clinical question posed. An evidence table was compiled to organize the study data and identify key points. The review brings strong evidence that preoperative scalp shaving does not confer any benefit against postoperative wound infection and, paradoxically, may lead to higher rates of infection. Because hair removal neither contributes benefits to the surgery itself nor decreases the risk of wound infection but has considerable cosmetic value for the patient, many of the authors recommended that cranial surgeries should be done without hair shaving.

UI MeSH Term Description Entries
D011300 Preoperative Care Care given during the period prior to undergoing surgery when psychological and physical preparations are made according to the special needs of the individual patient. This period spans the time between admission to the hospital to the time the surgery begins. (From Dictionary of Health Services Management, 2d ed) Care, Preoperative,Preoperative Procedure,Preoperative Procedures,Procedure, Preoperative,Procedures, Preoperative
D003399 Craniotomy Surgical incision into the cranium. Craniectomy,Craniectomies,Craniotomies
D006197 Hair A filament-like structure consisting of a shaft which projects to the surface of the SKIN from a root which is softer than the shaft and lodges in the cavity of a HAIR FOLLICLE. It is found on most surfaces of the body. Fetal Hair,Hair, Fetal,Lanugo,Fetal Hairs,Hairs,Hairs, Fetal
D006204 Hair Removal Methods used to remove unwanted facial and body hair. Depilation,Electrolytic Depilation,Epilation,Depilation, Electrolytic,Depilations,Depilations, Electrolytic,Electrolytic Depilations,Epilations,Hair Removals,Removal, Hair,Removals, Hair
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012535 Scalp The outer covering of the calvaria. It is composed of several layers: SKIN; subcutaneous connective tissue; the occipitofrontal muscle which includes the tendinous galea aponeurotica; loose connective tissue; and the pericranium (the PERIOSTEUM of the SKULL). Scalps
D013527 Perioperative Nursing Nursing care of the surgical patient before, during, and after surgery. Surgical Nursing,Nursing, Perioperative,Perianesthesia Nursing,Nursing, Perianesthesia
D013530 Surgical Wound Infection Infection occurring at the site of a surgical incision. Postoperative Wound Infection,Infection, Postoperative Wound,Infection, Surgical Wound,Surgical Site Infection,Wound Infection, Postoperative,Wound Infection, Surgical,Infection, Surgical Site,Infections, Postoperative Wound,Infections, Surgical Site,Infections, Surgical Wound,Postoperative Wound Infections,Surgical Site Infections,Surgical Wound Infections,Wound Infections, Postoperative,Wound Infections, Surgical
D019635 Neurosurgical Procedures Surgery performed on the nervous system or its parts. Procedures, Neurosurgical,Surgical Procedures, Neurologic,Neurologic Surgical Procedure,Neurologic Surgical Procedures,Neurosurgical Procedure,Procedure, Neurologic Surgical,Procedure, Neurosurgical,Procedures, Neurologic Surgical,Surgical Procedure, Neurologic

Related Publications

Sherly Sebastian
May 1984, Nederlands tijdschrift voor geneeskunde,
Sherly Sebastian
September 2019, Archives of physical medicine and rehabilitation,
Sherly Sebastian
October 2019, World journal of urology,
Sherly Sebastian
July 2021, International journal of oral and maxillofacial surgery,
Sherly Sebastian
January 1982, Acta chirurgica Scandinavica,
Sherly Sebastian
May 2024, European journal of orthopaedic surgery & traumatology : orthopedie traumatologie,
Sherly Sebastian
September 1990, Today's OR nurse,
Copied contents to your clipboard!