Evaluation of two methods of preoperative hair removal and their relationship to postoperative wound infection

Abstract

Introduction: 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. Methodology: 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. Results: 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. 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.

Antiseptic Skin Preparation for Preventing Surgical Site Infection at Caesarean Section

“…In this study, the commonest causative organism isolated for SSI was Staphylococcus aureus followed by Escherichia coli. This is similar to the findings of other investigators in Ile-Ife [16] [17]. Shittu et al [17] found that Staphylococcus species made up about 41% of the isolates from infected wounds while Adisa et al [16] found that Staphylococcus aureus made up 62.5% of the isolates found in their study.…”

“…This is similar to the findings of other investigators in Ile-Ife [16] [17]. Shittu et al [17] found that Staphylococcus species made up about 41% of the isolates from infected wounds while Adisa et al [16] found that Staphylococcus aureus made up 62.5% of the isolates found in their study. This is in keeping with the fact that most SSI occurs from commensal organisms such as Staphylococci species which are consistently present on a patient's skin, compared with transient organisms that are more easily removed [18].…”

“…The reviewers concluded that "little evidence was available from the included randomised controlled trials to evaluate different agent forms, concentrations and methods of skin preparation for preventing infection following caesarean section" [3]. Most of the cases of SSI were of the superficial type which was similar to findings of other investigators [13] [16]. In this study, the commonest causative organism isolated for SSI was Staphylococcus aureus followed by Escherichia coli.…”

Antiseptic Skin Preparation for Preventing Surgical Site Infection at Caesarean Section

“…In this study, the commonest causative organism isolated for SSI was Staphylococcus aureus followed by Escherichia coli. This is similar to the findings of other investigators in Ile-Ife [16] [17]. Shittu et al [17] found that Staphylococcus species made up about 41% of the isolates from infected wounds while Adisa et al [16] found that Staphylococcus aureus made up 62.5% of the isolates found in their study.…”

“…This is similar to the findings of other investigators in Ile-Ife [16] [17]. Shittu et al [17] found that Staphylococcus species made up about 41% of the isolates from infected wounds while Adisa et al [16] found that Staphylococcus aureus made up 62.5% of the isolates found in their study. This is in keeping with the fact that most SSI occurs from commensal organisms such as Staphylococci species which are consistently present on a patient's skin, compared with transient organisms that are more easily removed [18].…”

“…The reviewers concluded that "little evidence was available from the included randomised controlled trials to evaluate different agent forms, concentrations and methods of skin preparation for preventing infection following caesarean section" [3]. Most of the cases of SSI were of the superficial type which was similar to findings of other investigators [13] [16]. In this study, the commonest causative organism isolated for SSI was Staphylococcus aureus followed by Escherichia coli.…”

WHO Safe Surgery Checklist for Cesarean Section (CS) Delivery: Practice and Associated Factors Among Physicians in Rwanda

“…Studies from developed countries have shown that the implementation of such prophylactic measures is critical in preventing complications like deep vein thrombosis [ 16 , 17 ]. The finding that 97.8% of medical doctors do not perform intraoperative hair removal during CD indicates a high adherence to modern evidence‐based guidelines that recommend avoiding unnecessary hair removal to reduce the risk of SSIs, reflecting effective dissemination of best practices and possibly contributing to improved patient safety and resource utilization within the healthcare system, and this is in accordance with the current literature [ 18 , 19 ]. The high rate of regional anesthesia use (97.83%) and the near‐universal application of oxytocin or carbetocin (97.8%) for uterine contraction management are positive aspects, reflecting adherence to effective practices for pain management and hemorrhage prevention during CSs [ 20 ].…”

A comparison of postoperative wound infection rates after preoperative hair removal with razors versus clippers in a sub-urban setting

“…The need to provide an effective and safe method of hair removal for surgery has been a concern for surgeons. We studied 158 operative sites in 146 patients which is comparable to similar work by Adisa et al and Mukesh et al 11,16 However, in terms of demographics, this study involved an older population, with more males compared to that of Adisa et al and Mukesh et al 11,16 Also, most of the surgeries included open herniorrhaphies, similar to that by Adisa and colleagues. 16 Razors make direct contact with the skin, clearing it of hair.…”

Antiseptic Skin Preparation for Preventing Surgical Site Infection at Caesarean Section

“…In this study, the commonest causative organism isolated for SSI was Staphylococcus aureus followed by Escherichia coli. This is similar to the findings of other investigators in Ile-Ife [16] [17]. Shittu et al [17] found that Staphylococcus species made up about 41% of the isolates from infected wounds while Adisa et al [16] found that Staphylococcus aureus made up 62.5% of the isolates found in their study.…”

“…This is similar to the findings of other investigators in Ile-Ife [16] [17]. Shittu et al [17] found that Staphylococcus species made up about 41% of the isolates from infected wounds while Adisa et al [16] found that Staphylococcus aureus made up 62.5% of the isolates found in their study. This is in keeping with the fact that most SSI occurs from commensal organisms such as Staphylococci species which are consistently present on a patient's skin, compared with transient organisms that are more easily removed [18].…”

“…The reviewers concluded that "little evidence was available from the included randomised controlled trials to evaluate different agent forms, concentrations and methods of skin preparation for preventing infection following caesarean section" [3]. Most of the cases of SSI were of the superficial type which was similar to findings of other investigators [13] [16]. In this study, the commonest causative organism isolated for SSI was Staphylococcus aureus followed by Escherichia coli.…”

WHO Safe Surgery Checklist for Cesarean Section (CS) Delivery: Practice and Associated Factors Among Physicians in Rwanda

“…Studies from developed countries have shown that the implementation of such prophylactic measures is critical in preventing complications like deep vein thrombosis [ 16 , 17 ]. The finding that 97.8% of medical doctors do not perform intraoperative hair removal during CD indicates a high adherence to modern evidence‐based guidelines that recommend avoiding unnecessary hair removal to reduce the risk of SSIs, reflecting effective dissemination of best practices and possibly contributing to improved patient safety and resource utilization within the healthcare system, and this is in accordance with the current literature [ 18 , 19 ]. The high rate of regional anesthesia use (97.83%) and the near‐universal application of oxytocin or carbetocin (97.8%) for uterine contraction management are positive aspects, reflecting adherence to effective practices for pain management and hemorrhage prevention during CSs [ 20 ].…”

A comparison of postoperative wound infection rates after preoperative hair removal with razors versus clippers in a sub-urban setting

“…The need to provide an effective and safe method of hair removal for surgery has been a concern for surgeons. We studied 158 operative sites in 146 patients which is comparable to similar work by Adisa et al and Mukesh et al 11,16 However, in terms of demographics, this study involved an older population, with more males compared to that of Adisa et al and Mukesh et al 11,16 Also, most of the surgeries included open herniorrhaphies, similar to that by Adisa and colleagues. 16 Razors make direct contact with the skin, clearing it of hair.…”

Antiseptic Skin Preparation for Preventing Surgical Site Infection at Caesarean Section

“…In this study, the commonest causative organism isolated for SSI was Staphylococcus aureus followed by Escherichia coli. This is similar to the findings of other investigators in Ile-Ife [16] [17]. Shittu et al [17] found that Staphylococcus species made up about 41% of the isolates from infected wounds while Adisa et al [16] found that Staphylococcus aureus made up 62.5% of the isolates found in their study.…”

“…This is similar to the findings of other investigators in Ile-Ife [16] [17]. Shittu et al [17] found that Staphylococcus species made up about 41% of the isolates from infected wounds while Adisa et al [16] found that Staphylococcus aureus made up 62.5% of the isolates found in their study. This is in keeping with the fact that most SSI occurs from commensal organisms such as Staphylococci species which are consistently present on a patient's skin, compared with transient organisms that are more easily removed [18].…”

“…The reviewers concluded that "little evidence was available from the included randomised controlled trials to evaluate different agent forms, concentrations and methods of skin preparation for preventing infection following caesarean section" [3]. Most of the cases of SSI were of the superficial type which was similar to findings of other investigators [13] [16]. In this study, the commonest causative organism isolated for SSI was Staphylococcus aureus followed by Escherichia coli.…”

WHO Safe Surgery Checklist for Cesarean Section (CS) Delivery: Practice and Associated Factors Among Physicians in Rwanda

“…Studies from developed countries have shown that the implementation of such prophylactic measures is critical in preventing complications like deep vein thrombosis [ 16 , 17 ]. The finding that 97.8% of medical doctors do not perform intraoperative hair removal during CD indicates a high adherence to modern evidence‐based guidelines that recommend avoiding unnecessary hair removal to reduce the risk of SSIs, reflecting effective dissemination of best practices and possibly contributing to improved patient safety and resource utilization within the healthcare system, and this is in accordance with the current literature [ 18 , 19 ]. The high rate of regional anesthesia use (97.83%) and the near‐universal application of oxytocin or carbetocin (97.8%) for uterine contraction management are positive aspects, reflecting adherence to effective practices for pain management and hemorrhage prevention during CSs [ 20 ].…”

A comparison of postoperative wound infection rates after preoperative hair removal with razors versus clippers in a sub-urban setting

“…The need to provide an effective and safe method of hair removal for surgery has been a concern for surgeons. We studied 158 operative sites in 146 patients which is comparable to similar work by Adisa et al and Mukesh et al 11,16 However, in terms of demographics, this study involved an older population, with more males compared to that of Adisa et al and Mukesh et al 11,16 Also, most of the surgeries included open herniorrhaphies, similar to that by Adisa and colleagues. 16 Razors make direct contact with the skin, clearing it of hair.…”