Preoperative hair removal to surgical site infection

Derby Hospitals NHS Foundation Trust, Derby, England, United Kingdom
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 02/2006; 3(3):CD004122. DOI: 10.1002/14651858.CD004122.pub3
Source: PubMed


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.

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Available from: Judith Tanner, Apr 30, 2015
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    • "Follicles of hair at the surgical site have always been viewed as a risk for bacteria and SSI. However, there is no evidence to support hair removal and a subsequent reduction in SSI rates [31]. Nevertheless, for hirsute patients undergoing elective colon surgery, a case can be made that hair removal may be of logistical value during the course of the operation. "
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    ABSTRACT: Infections at the surgical site continue to occur in as many as 20% of elective colon resection cases. Methods to reduce these infections are inconsistently applied. Surgical site infection (SSI) is the result of multiple interactive variables including the inoculum of bacteria that contaminate the site, the virulence of the contaminating microbes, and the local environment at the surgical site. These variables that promote infection are potentially offset by the effectiveness of the host defense. Reduction in the inoculum of bacteria is achieved by appropriate surgical site preparation, systemic preventive antibiotics, and use of mechanical bowel preparation in conjunction with the oral antibiotic bowel preparation. Intraoperative reduction of hematoma, necrotic tissue, foreign bodies, and tissue dead space will reduce infections. Enhancement of the host may be achieved by perioperative supplemental oxygenation, maintenance of normothermia, and glycemic control. These methods require additional research to identify optimum application. Uniform application of currently understood methods and continued research into new methods to reduce microbial contamination and enhancement of host responsiveness can lead to better outcomes.
    Full-text · Article · Dec 2013
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    • "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. "
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    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.
    Full-text · Article · Sep 2013 · Arab Journal of Urology
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    • "Second, the overall rates of SSI of 17.9% in this study are higher than those reported in some previous studies [24,25]; nevertheless, they are similar to the pre-study rates at the participating hospitals and those reported in other studies [26] and are lower than the rates reported in trials that used the CDC definition of infection and had adequate follow-up [2,12,13], as we did in this trial. In this study we universally enforced standard of care preventive measures (for example, administering systemic prophylactic antibiotics within the 30 minutes before the first incision was made and, if needed, clipping hair immediately before surgery) [27,28]. However, we did not use chlorhexidine-alcohol as the skin preparation agent; although the povidone-iodine we used possesses broad spectrum antimicrobial activity [27], a recent randomized controlled trial demonstrated that preoperative cleansing of the patient’s skin with chlorhexidine-alcohol is superior to cleansing with povidone-iodine for preventing SSI after clean-contaminated surgery [5]. "
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    ABSTRACT: An antimicrobial dressing containing ionic silver was found effective in reducing surgical-site infection in a preliminary study of colorectal cancer elective surgery. We decided to test this finding in a randomized, double-blind trial. Adults undergoing elective colorectal cancer surgery at two university-affiliated hospitals were randomly assigned to have the surgical incision dressed with Aquacel Ag Hydrofiber dressing or a common dressing. To blind the patient and the nursing and medical staff to the nature of the dressing used, scrub nurses covered Aquacel Ag Hydrofiber with a common wound dressing in the experimental arm, whereas a double common dressing was applied to patients of control group. The primary end-point of the study was the occurrence of any surgical-site infection within 30 days of surgery. A total of 112 patients (58 in the experimental arm and 54 in the control group) qualified for primary end-point analysis. The characteristics of the patient population and their surgical procedures were similar. The overall rate of surgical-site infection was lower in the experimental group (11.1% center 1, 17.5% center 2; overall 15.5%) than in controls (14.3% center 1, 24.2% center 2, overall 20.4%), but the observed difference was not statistically significant (P = 0.451), even with respect to surgical-site infection grade 1 (superficial) versus grades 2 and 3, or grade 1 and 2 versus grade 3. This randomized trial did not confirm a statistically significant superiority of Aquacel Ag Hydrofiber dressing in reducing surgical-site infection after elective colorectal cancer surgery. NCT00981110.
    Full-text · Article · May 2012 · World Journal of Surgical Oncology
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