Preoperative Hair Removal: A Systematic Review

Abstract

Preparing patients for surgery has traditionally included the routine removal of body hair from the intended surgical wound site. However, there are studies which claim that preoperative hair removal is deleterious to patients, perhaps by causing surgical site infections (SSIs), and should not be carried out. The objective of this review was to determine if routine preoperative hair removal results in fewer SSIs than not removing hair. Eleven randomised controlled trials were included in this review. There is insufficient evidence to state whether removing hair impacts on surgical site infection or when is the best time to remove hair. However, if it is necessary to remove hair then both clipping and depilatory creams results in fewer SSIs than shaving using a razor.

Jordanian Nurses’ Knowledge of Preventing Surgical Site Infections in Acute Care Settings

“…In contrast [2], reported that preoperative hair removal must be performed as close to the surgery time as possible. However [41], conducted a systematic review regarding preoperative hair removal including eleven randomized controlled trials and they concluded that there was insufficient evidence to state when is the best time to remove hair. Such contradictory findings may affect nurses' conception regarding the proper measures to be implemented to prevent SSIs and put them in state of uncertainty.…”

Perioperative Supplemental Oxygen Therapy and Surgical Site Infection

“…The effects of timely antibiotic drug therapy, 52 avoidance of shaving, 53 and maintenance of normothermia 2 and normoglycemia 28 are evidence-based practices that are known to lower the infection rate. Careful adherence to such guidelines was not evident in all studies.…”

Perioperative hair removal in the 21st century: Utilizing an innovative vacuum-assisted technology to safely expedite hair removal before surgery

“…Evidence-based practice suggests that hair removal using an exposed blade or razor may increase the risk of wound contamination due to the presence of microscopic nicks or scratches that occur during the shaving process. [8][9][10][11][12] These microscopic injuries are rapidly colonized, increasing the microbial skin burden leading to an increased risk of wound infection. 11 The 1999 Centers for Disease Control and Prevention Guidelines for the Prevention of Surgical Site Infections indicate that, "If hair is to be removed, remove immediately before the operation, preferably with electric clippers" (Category 1A evidence-based).…”