• Vol. 31 No. 2, 150–154
  • 15 March 2002

Cosmesis in Neurosurgery: Is the Bald Head Necessary to Avoid Postoperative Infection?



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Aim: The aims of this study were to prospectively investigate the incidence of postoperative wound infection following elective cranial surgery, when scalp hair removal was limited to the line of the incision, and to see if there was an increased risk of infection.

Materials and Methods: This is an observational study of 57 consecutive adult elective cases operated upon without head shave (between July 1998 and December 1998). The method of scalp preparation is described.

Results: During the follow-up period, there was 1 case (1.75%) of postoperative wound infection. This was compared with retrospective data, and was not found to be statistically significant.

Discussion: In a review of earlier studies and a search into the history of aseptic surgery, no scientific ground for the practice of shaving was found. We suggest that there is no advantage in shaving patients in terms of reducing wound infection rates.

Preoperative shaving for cranial neurosurgical procedures, as recommended in textbooks, is still a traditional practice in Singapore. Hair has been associated with uncleanliness and its removal, particularly by shaving, has been associated in the minds of practitioners and the public with cleanliness and reducing the risk of infections.

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