Preoperative hair removal to surgical site infection

Derby Hospitals NHS Foundation Trust, Derby, England, United Kingdom
Cochrane database of systematic reviews (Online) (Impact Factor: 5.94). 02/2006; 3(3):CD004122. DOI: 10.1002/14651858.CD004122.pub3
Source: PubMed

ABSTRACT When people are being prepared for surgery removing body hair from the area of the surgical incision may reduce the chance of the surgical site becoming infected. Traditionally people undergoing surgery have body hair removed from the intended surgical wound site as this is thought to reduce the chance of the surgical site becoming infected. Three methods of hair removal are currently used; shaving with a razor, clipping with clippers and using a cream which dissolves the hair. There is insufficient evidence for removing hair before surgery by shaving or removing hair using a cream, on the rate of surgical site infection. However if it is necessary to remove hair then it is preferable to use clippers rather than shaving with a razor as this results in fewer surgical site infections.

Download full-text


Available from: Judith Tanner, Apr 30, 2015
  • Source
    • "Hair removal with clipping or depilatory creams results in fewer surgical-site infections than does shaving with a razor. However, there was no difference in the infection rate in patients who had hair removed on the day before or the day of surgery, regardless of the method of hair removal [50]. Skin and nasal sterilisation has been evaluated as a means of reducing prosthesis infection by attempting to eradicate Staphylococcus contamination. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Introduction We reviewed retrospectively the use of penile prostheses, including the indications and complications of penile prosthesis surgery. Methods We identified publications and the reported advances in penile prosthesis surgery between 1987 and 2012 in Pub-Med, and published information from American Medical Systems, Inc. (Minnetonka, MN, USA) and Coloplast Corporation (Humlebaek, Denmark), using the keywords ‘penile prosthesis’, ‘erectile dysfunction’, ‘mechanical reliability’, ‘complications’ and ‘infection’. Results We describe the novel indications for the use of penile prostheses, the significant advances in implant designs with improved mechanical reliability, the changing landscape of device infection, and the current management of complications. Sixty-eight publications with a grade A, B and C level of evidence are cited. Conclusion The clinical indications to implant a penile prosthesis have expanded beyond organic erectile dysfunction. With the many different devices currently available, the choice of which device to implant can be tailored based on an individual’s unique medical conditions, manual dexterity and expectations, and surgeon preference. There must be a conscious effort to prevent device infection, in the light of the development of increasingly virulent organisms. Penile prosthesis surgery is an integral part of the treatment of erectile dysfunction when non-surgical options fail or are contraindicated.
    09/2013; 11(3):245–253. DOI:10.1016/j.aju.2013.05.002
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Surgeons, like other clinicians, are obliged to keep up-to-date with the rapidly expanding knowledge. The information explosion particularly in the electronic media, methodological problems associated with clinical trials in surgery and failure to appraise critically the existing knowledge has made application of high quality evidence in surgical decision-making difficult. This article examines the functioning and the role of Cochrane collaboration and in particular, the systematic reviews undertaken by it, in the assimilation and dissemination of robust evidence for use in evidence-based surgery.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Surgical site infection (SSI) is the commonest hospital acquired infection that occurs in early postoperative period in surgical patients and accounts for 38% of infections in surgical patients and 31.1% of all infections in trauma patients. Ifs frequency increase parallels increase in number of risk factors. Prevention of peri-operative infection necessitates management directed at optimizing of patient factors like smoking, nutritional factors, immune-suppression, obesity and cardiovascular status. Use of principles like antibiotic prophylaxis, aseptic theatre conditions, respect of soft tissues during operation, local therapy and other modern patient safety practices is mandatory. Antibiotic prophylaxis should be started early pre-operatively at least 30-60 minutes before incision and antibiotic level exceeding minimal inhibitory concentration for infecting organism or before inflation of a tourniquet if applicable to closure of wound. Aiming at short preoperative stay in hospital, and pre-washing of the area concerned before cleaning with antiseptic are also imperative in reducing SSI. Preoperative skin preparation is an important element in prevention of infection, but removes only up to 80% of skin flora. Standard surgical antisepsis is an accepted method and involves scrubbing with antiseptic solutions. Chlorhexidine gluconate compared with povodine iodine showed a prolonged reduction in skin contamination and with less toxicity and skin irritation. Aqueous surgical hand scrubs are equivalent to traditional scrubs with regard to reduction of skin contamination, with higher surgeons protocol compliancy compared to traditional scrubs. The use of laminar flow and ultra-violet light in theatre is associated with decreased rates of postoperative skin infections and contamination. Respect of soft tissues during surgery through decrease in excessive use of diathermy, contusions and excessive tension is advised. Wound closure without tension and no dead space is encouraged. Issues of wound drainage have not been shown to reduce rates of infection. When used, closed suction drainage is better than open drain. SSI is a common complication and it is in the interest of the surgeon and the patient that it is prevented as it can be associated with morbidity, mortality and increased resource utilization. This article will deal with peri-operative management of the orthopaedic patient using evidence based benefits to the current practices available from recent updates, reviews and prospective randomized control trials, and some retrospective studies.
Show more