Abstract
When a surgical operation is to be conducted through a hair bearing part of the body, hair removal is often performed. This study aimed to evaluate the relationship of two methods of preoperative hair removal to postoperative wound infection in a developing country where razor shaving is very popular. Consecutive consenting patients scheduled to have such operations were randomized into two groups. One group had hair removal by shaving with a razor blade while the other had hair removed by depilatory cream. Adequacy of hair removal and presence of skin injuries and/or reactions were noted preoperatively. Details of the procedures were recorded and patients were then assessed for postoperative wound infection. A total of 165 patients were studied. Of the 79 patients who had hair removal by depilatory cream, hair was completely removed in 70 (88.6%) compared to 53 (61.6%) of the 86 patients who had razor hair shaving (p < 0.0001). Skin injuries were noted in 24 (27.9%) of the razor group and 3 (3.8%) of patients who had depilatory cream, (p = 0.001). Thirteen patients (7.9%) had postoperative wound infection including 2 (2.5%) in the depilatory cream group and 11 (12.8%) of the razor group. A significant association was found between preoperative skin injuries and postoperative wound infections. Preoperative hair removal with razor shaving predisposes to skin injuries which in turn significantly influence postoperative wound infection rates. Such injuries and resultant wound infection are fewer when depilatory cream is used for hair removal.
Highlights
When a surgical operation is to be conducted through a hair bearing part of the body, hair removal is often performed
Those who advocate the practice of preoperative hair removal do so in the belief that presence of hairs can interfere with skin incisions and the subsequent closure as well as the application of adhesive drapes and wound dressings [15]
Seventeen patients, including ten in the razor group and seven in the depilatory group who missed some days in their follow-up clinic attendance, were excluded from the final analysis
Summary
When a surgical operation is to be conducted through a hair bearing part of the body, hair removal is often performed. Conclusion: Preoperative hair removal with razor shaving predisposes to skin injuries which in turn significantly influence postoperative wound infection rates Such injuries and resultant wound infection are fewer when depilatory cream is used for hair removal. A systematic review of several randomized controlled trials in the Cochrane Database, observed that if it is necessary to remove hair, both clipping and depilatory cream result in fewer surgical site infections than shaving with a razor. It advocated for more trials comparing hair removal with a razor with depilatory cream at different times and settings, among other factors [6]
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