[Cranial Procedures without shaving. A 1-year experience at the Hospital São João. ]

Scalp shaving has been a ritual usually said to make easier orientation and surgical access and also to prevent local infection. However, this last aspect has been challenged in several publications and progressive evidence on favourable psychological effects of non-shaved patients has accumulated. The authors review 328 intracranial surgeries performed without scalp shaving from 1 October 1999 to 30 September 2000 in the Department of Neurosurgery of Hospital de S.João. All patients were included except those undergoing approaches, such as transphenoidal external ventricular drainages, removal of collocated non-organic materials and surgery for infections. The technique was implemented in patient having CSF shunting only during the second half of the study period. Antibiotic prophylaxis was the same previously used in the Department. The infection rate was 1.82%. The authors comment the disadvantages and benefits of the technique, remarking positive psychological effects for the patient.