A comparison of postoperative wound infection rates after preoperative hair removal with razors versus clippers in a sub-urban setting

Abstract

Background: Preoperative hair removal from hair bearing areas is widely practised. Razors are widely used in poor resource settings despite concerns that they may be associated with surgical wound infection. In contrast, clippers are not commonly used in this setting because they are expensive. Objective was to compare effectiveness of depilation, cost and wound infection rates following the use of razors and clippers in preoperative hair removal in clean surgical operations in a resource-poor setting.Methods: A randomized controlled study was carried out over 1 year. Surgeries were randomized into two groups who had preoperative hair removal using razors and clippers respectively. The participants were then monitored postoperatively for wound infection.Results: Seventy-nine operative sites were assigned to each group. Seventy-six (96%) and 65 (82%) operative sites in the razor-shaved and hair-clipped group respectively had complete hair removal (p=0.005). Twenty-three (29%) and 4 (5%) operative sites in the razor-shaved and hair-clipped group respectively had some degree of skin injury (p=0.000). The total rate of wound infection was 5.7%, however, 7 (8.9%) and 2 (2.5%) operative sites in the razor-shaved and hair-clipped groups respectively were infected (p=0.167). The mean cost incurred in the razor-shaved and hair-clipped group was approximately N587±1,644.60 and N 1,272±883.46 respectively (p=0.001). Conclusions: Though razors provided more effective depilation, they caused more surface abrasions and were associated with more wound infections, though not statistically significant. Clippers are however associated with greater cost and this could be a major constraint where resources are limited.