Surgical Site Infections in Ear Surgery: Hair Removal Effect

Abstract

POSTERSmanagement, revision surgery, postopeartive flying time, facial nerve overhanging issues,and training juniors.Results: Of the questionnaires we received (182/197), 77 surgeons perform 6-15 operations/year, most (107) under GA. 123 advise stapes surgery in unilateral disease. 119 always advise patients about trying a hearing aid. 130 perform second side stapes surgery and most wait for at least 6 months for second side surgery. Stapedotomy is preferred (123), stapedectomy (11). Cause prosthesis is the most common. 57 always, and 47 never use a veingraft. 67 use laser. 64 prefer daycase surgery. 37 would abandon surgery for a 50% or more overhanging facial nerve. 34 have encountered a "gusher." 112 would recommend revision surgery. Most would advise patients "flying" after 6 weeks. Conclusion:In UK, the majority prefer GA, an overnight stay, a hearing aid trial, carrying out surgery in unilateral disease, 2nd side surgery, stapedotomy, inserting the prosthesis after removal of the stapes, advise revision surgery in conductive loss, and are willing to train trainees with an otological interest. Method: This is a retrospective case review at a tertiary care referral center. Patients included underwent a middle fossa craniotomy for repair of spontaneous CSF otorrhea between January 2007 and December 2011. The main outcome measure is the presence or absence of a dehiscent semicircular canal observed during spontaneous CSF leak repair. Otology/NeurotologyResults: Thirty-three ears in 31 patients underwent surgical repair for spontaneous CSF otorrhea via a middle fossa craniotomy. The average age at the time of repair was 60.5 years and 80.6% of patients were women. The left ear was more commonly involved in 66.7% of cases. An encephalocele was observed in 69.7% of ears. A dehiscence of the superior canal was observed in 15.2% of ears (16.1% of individuals). All ears with a dehiscent superior canal were also observed to have an encephalocele. No significant difference in age, BMI, or gender was noted between those patients with or without a superior canal dehiscence. Conclusion:The incidence of superior semicircular canal dehiscence in ears with spontaneous otorrhea is 15.2%. This incidence is greater than that reported in a temporal bone study of ears not selected for CSF otorrhea. Results: Fifty-eight cases were men and 78 cases were women. Demographic data between the 2 groups-age, gender, the side of operated ear, types of anesthesia, emergency or elective setting, BMI, history of alcohol drinking or smoking, underlying diseases, operative time, and the length of stay in the hospital-showed no significant difference. A postoperative surgical site infection was developed in 5 patients: 3 in the group with hair removal (5%) and 2 in the group without hair removal (3%) (P = .674, Fisher's exact test). All infected cases had mastoidectomy surgery. Otology/Neurotology Conclusion:Surgical site infection rate between the groups with and without hair removal showed no difference. Hair removal in ear surgery via posta...

Preoperative hair removal to reduce surgical site infection

“…Sample sizes varied widely. Eight studies included between 50 and 100 participants (Domes 2011;Goëau-Brissonnière 1987;Ilankovan 1992;Lu 2002;Nascimento 1991;Powis 1976;Rojanapirom 1992;Thorup 1985), and 11 studies had between 101 and 253 participants (Abouzari 2009;Breiting 1981;Grober 2013;Karegoudar 2012;Kattipattanapong 2013;Sun 2014;Suvera 2013;Taylor 2005;Thur de Koos 1983). Three studies had between 400 and 800 participants (Celik 2007;Court-Brown 1981;Seropian 1971).…”

“…Nine studies compared hair removal versus no hair removal: three using clippers (Abouzari 2009;Lu 2002), eight using razors (Abouzari 2009;Celik 2007;Court-Brown 1981;Ilankovan 1992;Kattipattanapong 2013;Nascimento 1991;Rojanapirom 1992;Sun 2014), and one using cream (Court-Brown 1981). Seven studies compared razors versus clippers (Abouzari 2009;Domes 2011;Grober 2013;Ko 1992;Taylor 2005), and 10 studies compared razors with cream (Adisa 2011 ;Breiting 1981;Court-Brown 1981;Goëau-Brissonnière 1987;Karegoudar 2012;Powis 1976;Seropian 1971;Suvera 2013;Thorup 1985;Thur de Koos 1983).…”

Does perioperative skin preparation reduce surgical site infection?

“…Whether hair is removed by clipping, shaving, or chemical depilation, when performed on the day of surgery the relative risk of SSI is lower than if performed the day before surgery. 2 Kattipattanapong et al 3 conducted a randomized controlled trial of adult patients undergoing ear and/or mastoid surgeries via a postauricular approach. In the hair-removal group, the area was shaved with a dry razor, otherwise skin preparation and wound closure was performed the same in both groups.…”

“…4 Similarly, in ear and mastoid SSI, Staphylococcus aureus was the most frequently isolated microorganism. 3 Potential skin pathogens currently targeted in the head and neck should also include gram-negative flora if there is oral bacterial exposure.…”

Depilation of the external auditory canal in transcanal and endaural otosurgery

“…Тем не менее было опубликовано несколько работ, указываю щих на то, что предоперационное сбривание волос увеличивает риск инфицирования послеоперационной раны вследствие нанесения микротравмы бритвой и нарушения целостности кожного по -крова 1 [13,14]. По данным W. Kattipattanapong et al, предоперационное сбривание волос вовсе никак не влияет на частоту инфицирования хирургического поля [15].…”