Cranial procedures without hair removal

Area of Science:

• Neurosurgery
• Surgical Techniques

Background:

• The practice of hair removal before cranial neurosurgery has been standard, but its necessity is questioned.
• Winston's 1992 publication highlighted the feasibility of neurosurgery without hair removal.

Purpose of the Study:

• To evaluate the safety and efficacy of performing cranial neurosurgery without removing hair.
• To assess the incidence of infection and other complications in patients undergoing neurosurgery without hair removal.

Main Methods:

• A prospective trial involving 346 patients undergoing elective cranial surgery without hair removal.
• Modified preparation protocols using chlorhexidine/water or iodophor, with a single perioperative antibiotic dose.
• Inclusion of various neurosurgical procedures: tumor, trauma, aneurysm, epilepsy, functional, shunts, and abscess treatments.

Main Results:

• No infections or complications were observed in 346 cranial operations performed without hair removal.
• The study included a diverse range of neurosurgical procedures, demonstrating broad applicability.
• Patients expressed strong positive preferences for retaining their hair.

Conclusions:

• Cranial neurosurgery without hair removal is a safe procedure with no discernible increase in infection risk.
• Simple techniques can effectively manage hair during surgery, enhancing patient satisfaction.
• The study advocates for wider adoption of the no-hair-removal technique in neurosurgery.