Article

Hair removal policies in clean surgery: systematic review of randomized, controlled trials.

Dutch Working Party on Infection Prevention, Leiden, the Netherlands.
Infection Control and Hospital Epidemiology (Impact Factor: 4.02). 01/2006; 26(12):923-8. DOI: 10.1086/505454
Source: PubMed

ABSTRACT To determine whether certain hair removal policies are better than others to prevent surgical-site infections in patients undergoing clean surgery.
Publications were retrieved by a systematic search of Medline, the Cochrane Library, and EMBASE up to February 2005. Additionally, the reference lists of all identified trials were examined. All randomized trials, quasi-randomized trials, and systematic reviews or meta-analyses of randomized or quasi-randomized trials comparing hair removal policies in clean surgery were selected. Trials involving patients undergoing cranial neurosurgery were excluded. Two reviewers independently assessed trial quality and extracted data. Disagreements were resolved by discussion with a third reviewer. Data from the original publications were used to calculate the relative risk or risk difference of surgical-site infection. Data for similar outcomes were combined in the analysis, where appropriate, with the use of a random effects model.
Four trials were included in the review. No eligible systematic review or meta-analysis of randomized or quasi-randomized trials was found. The quality of the trials and how they were reported were generally unsatisfactory. Evidence regarding whether preoperative hair removal has any effect was inconclusive. When hair removal was considered necessary, evidence about the best time for removal was inconclusive. There was some evidence that hair removal by clipper is superior to removal by razor.
Because of insufficient evidence as a basis for recommendations, the practical consequences for ward management were essential when the Dutch Working Party on Infection Prevention formulated its recommendations for hair removal policies. Large randomized, controlled trials are needed to determine the optimal policy for preoperative hair removal.

1 Bookmark
 · 
222 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Two preoperative male patients are scheduled for elective coronary artery bypass procedures. Both patients have hairy chest. Surgeon A orders preoperative removal of hair for his patient directly before surgery with clippers, and surgeon B does not order hair removal for his patient. Based on the literature, which preoperative hair removal practice will be most beneficial to avoid a surgical site infection?
    Perioperative Nursing Clinics 06/2008; 3(2):107-113.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Für die Vermeidung von Wundinfektionen stehen verschiedene Maßnahmen zur Verfügung. Die Teilnahme an einem Infektionssurveillanceprogramm, wie z. B. dem Krankenhaus-Infektions-Surveillance-System (KISS), ist gesetzlich verbindlich gefordert, hier steht ein spezielles Modul für die Erfassung postoperativer Wundinfektionen zur Verfügung. Patienteneigene Faktoren, wie z. B. Immunsuppression, Alkoholabusus, Nikotingebrauch oder Adipositas lassen sich meist nur in geringem Maße beeinflussen. Zu den präoperativen Maßnahmen gehören u. a. eine optimale Blutzuckereinstellung, Ausgleich einer Anämie oder einer Mangelernährung und die Behandlung von Infektionen bei elektiven Eingriffen. Auch eine Keimlastreduktion durch desinfizierende Körperwaschungen, Vermeidung einer scharfen Haarrasur, die Durchführung einer adäquaten Antibiotikaprophylaxe und eine korrekt durchgeführte chirurgische Hände- und Hautdesinfektion des Operationssitus stellen wichtige Maßnahmen dar. Intraoperativ sind ein Auskühlen des Patienten zu vermeiden und auf die strikte Einhaltung der Asepsis zu achten. Postoperative Maßnahmen umfassen eine sachgerechte Wundversorgung sowie ein zügiges Entfernen von Wunddrainagen.
    Der Orthopäde 41(1). · 0.51 Impact Factor
  • Krankenhaus-Hygiene + Infektionsverhütung 06/2009; 31(3):92–93.