Neurosurgery without shaving: indications and results

The objective of the investigation was to prevent the stigmatizing effect o f a totally or partially shaved head with openly visible signs of a head op eration, easing the reintegration of the patient into his daily life. After extended surface cleaning with a colourless, regular skin disinfection liq uid (undyed isopropanol/dibrom/propylenglycol solution) the hair was combed apart from the incision line before draping. Wound closure was performed a s usual, taking care to remove meticulously hair from the wound. To aid clo sure we made use of a 20% chlorhexidine jelly that holds the hair away from the incision. A neomycin ointment served for sealing the wound surface, no further dressing being used. After 215 cranial neurosurgical operations, a mong them 63 for tumours, 33 stereotactic procedures 18 shunt, 55 for torti collis and 46 other operations performed without shaving the hair, we saw o ne wound infection (0.5%). This percentage corresponds very well to our gen eral infection rate of 0.6%. All patients very much appreciated the offered opportunity and the result. If the objective is to give patients a psychol ogical advantage by preventing a partially bald head we think one can safel y refrain from the shaving procedure without risking a higher infection rat e.