Nonshaved cranial neurosurgery

Area of Science:

• Neurosurgery
• Surgical Infection Prevention

Background:

• Traditional practice recommends preoperative shaving for cranial neurosurgery.
• Emerging evidence suggests nonshaved surgery can be successful.
• This study aimed to compare surgical infection rates between shaved and nonshaved scalp preparations.

Purpose of the Study:

• To compare the surgical infection rates in cranial neurosurgical procedures using two distinct scalp preparation methods: shaved versus nonshaved.
• To evaluate the efficacy and safety of omitting preoperative shaving in specific neurosurgical contexts.

Main Methods:

• A comparative study of nonshaved versus shaved scalp preparation was conducted for non-emergency cranial neurosurgical procedures.
• Exclusion criteria for the nonshaved group included immunocompromised status, active infections, foreign material insertion, recent multiple surgeries, and traumatic wounds.
• Patients were monitored for surgical site infections, with specific criteria for exclusion based on survival duration and cause of death.

Main Results:

• The study included 225 cranial neurosurgical procedures over 29 months, with 89 in the nonshaved group and 136 in the shaved group.
• Surgical infection rates were 3.37% for the nonshaved group and 5.88% for the shaved group.
• The difference in infection rates between the two groups was not statistically significant (p>0.05).

Conclusions:

• Nonshaved scalp preparation is a safe and recommended practice for non-emergency cranial neurosurgical procedures.
• Omitting preoperative shaving does not increase the risk of surgical site infections in this patient population.
• This finding challenges traditional textbook recommendations and supports evidence-based practice in neurosurgery.