Nonshaved cranial surgery in black Africans: technical report and a medium-term prospective outcome study.

Abstract

Nonshaved neurosurgery, cranial or spinal, is well reported among Caucasians but hardly among native Africans. The ungroomed scalp hairs of black Africans have unique anthropological characteristics needing special attention for shaveless cranial surgery. A technical report of the execution of this surgical procedure among an indigenous patient population in a sub-Sahara African country is presented, as well as an outcome analysis in a prospective cohort over a 7-year period. A total of 303 patients (211 males, 70%) fulfilled the criteria for this study. The surgical procedure was primary in 278 (92%) and redo in 8%. It was emergency surgery in 153 (51%). They were trauma craniotomies or decompressive craniectomies in 95 cases (31%), craniotomies for tumour resections in 86 (28%), and the surgical dissections for other conditions in 122 (41%). The duration of surgery ranged from 30min to 8.5h, mean 2.5 (SD, 1.6), median 2. In-hospital clinical outcome was good (normal status or moderate deficit on dichotomized Glasgow outcome scale (GOS)) in 273 (90.1%) cases while surgical site infections occurred in only 10 cases (3.3%). The type of surgery, redo or primary, did not have any significant association with the in-hospital outcome (p = 0.5), nor with the presence of surgical site infection (SSI) (p = 0.7). The length of follow-up ranged from 2 to 63months (mean, 7) with no untoward complications reported so far. Medium-term outcome of nonshaved neurosurgery in this indigenous black Africans remains favourable with no attendant significant adverse after-effects.