Impact of Hair Removal on Surgical Site Infection Rates: A Prospective Randomized Noninferiority Trial

Area of Science:

• Infection Control
• Surgical Outcomes
• Clinical Trials

Background:

• Surgical site infections (SSIs) are a common healthcare-associated infection despite prevention efforts.
• Current guidelines on preoperative hair removal are based on limited evidence.
• The impact of hair removal on SSI rates requires further investigation.

Purpose of the Study:

• To evaluate the noninferiority of clipping hair versus no hair removal in preventing SSIs.
• To determine if preoperative hair clipping is a superior method for SSI reduction.

Main Methods:

• A single-center, prospective, randomized clinical trial involving 1,678 adult patients undergoing elective general surgery.
• Patients were randomized to either hair clipping or no hair removal.
• The primary endpoint was the proportion of patients without SSIs, defined by CDC criteria.

Main Results:

• The overall SSI rate was 6.12% in the clipped group and 6.32% in the not-clipped group.
• The absolute risk difference was -0.20% (95% CI -2.61% to 2.21%), which did not meet the noninferiority margin.
• No statistically significant difference in SSI rates was observed between the two groups.

Conclusions:

• Preoperative hair clipping does not significantly reduce surgical site infection rates in general surgery.
• Current practices of hair removal may not impact SSI prevention outcomes.
• Further research may be needed to confirm these findings in diverse surgical populations.