Neurosurgery without shaving: indications and results

Abstract

The objective of the investigation was to prevent the stigmatizing effect of a totally or partially shaved head with openly visible signs of a head operation, easing the reintegration of the patient into his daily life. After extended surface cleaning with a colourless, regular skin disinfection liquid (undyed isopropanol/dibrom/propylenglycol solution) the hair was combed apart from the incision line before draping.Wound closure was performed as usual, taking care to remove meticulously hair from the wound. To aid closure we made use of a 20% chlorhexidine jelly that holds the hair away from the incision. A neomycin ointment served for sealing the wound surface, no further dressing being used. After 215 cranial neurosurgical operations, among them 63 for tumours, 33 stereotactic procedures 18 shunt, 55 for torticollis and 46 other operations performed without shaving the hair, we saw one wound infection (0.5%). This percentage corresponds very well to our general infection rate of 0.6%. All patients very much appreciated the offered opportunity and the result. If the objective is to give patients a psychological advantage by preventing a partially bald head we think one can safely refrain from the shaving procedure without risking a higher infection rate.