Preoperative hair removal: a random prospective study of shaving versus clipping. The influence of hair-removal methods on wound infections. Shaving versus skin depilatory cream for preoperative skin preparation. A prospective study of wound infection rates. Does shaving the incision site increase the infection rate after spinal surgery? Pre-operative shaving and wound infection in appendectomy. Hair removal with long pulsed diode lasers: a comparison between two systems with different pulse structures. Preoperative shaving: patient and surgeon preferences and complications for the Gillies incision. Randomised controlled trial of perineal shaving versus hair cutting in parturients on admission in labor. [Preoperative skin preparation. A prospective study comparing a depilatory agent in shaving]. Skin pigmentation and texture changes after hair removal with the normal-mode ruby laser.
We report the results of a random, prospective study of electrical clipping versus routine razor shaving in the removal of hair immediately before operation. Two hundred patients having elective inguinal herniorrhaphy according to strict protocol were included in this study. Unsatisfactory skin preparation, as evidenced by gross cuts made in the skin during hair removal, was noted in 7% of those shaved and 4% of those clipped. Two subcutaneous wound infections occurred in the shaved group (2%) and one in the clipped group (1%). This study indicates that preoperative clipping of hair with electric barber's clippers immediately before operation is a safe, well tolerated procedure that does not increase the risk of postoperative wound infection. The influence of preoperative shaving v clipping on wound infection rate was studied in 1,013 patients undergoing elective operations at a single hospital. Patients were prospectively randomized to be either shaved or clipped the night before or the morning of operation. The AM clipper method was associated with significantly fewer infections than were the other methods, both at discharge and at 30-day follow-up. The greatest benefit was in the group with clean wounds. For each 1,000 patients treated, a savings of approximately $270,000 could be realized if the AM clipper method replaced shaving for preoperative hair removal. Preoperative shaving is deleterious, and the practice should be abandoned. A prospective, randomized study compared the effect of preoperative shaving versus chemical depilation on wound infection in 253 patients. No statistical difference was found between the two methods. Depilatory cream did save time by allowing hair to be removed the day before surgery and did offer an advantage in areas that were difficult to shave or if the patient was scheduled for diagnostic procedures and operations in the same operative area in close succession. A prospective randomized clinical study.
                To determine whether shaving the incision site before spinal surgery causes postsurgical infection.
                Spine surgeons usually shave the skin of the incision site immediately before surgery is performed. However, evidence from some surgical series suggests that presurgical shaving may increase the postsurgical infection rate. To our knowledge, no previously published studies have addressed this issue.
                A total of 789 patients scheduled to undergo spinal surgery were randomly allocated into 2 groups: those in whom the site of operation was shaved immediately before surgery (shaved group; 371 patients) and the patients in whom presurgical shaving was not performed (unshaved group; 418 patients). The mean duration of anesthesia and the infection rates in both groups were recorded and compared.
                The duration of anesthesia did not differ in the 2 groups (P > 0.05). A postoperative infection developed in 4 patients in the shaved group and in 1 patient in the nonshaved group (P < 0.01).
                The shaving of the incision site immediately before spinal surgery may increase the rate of postoperative infection. The study on the effects of shaving the skin on wound infections after appendectomy was done in 80 patients in 1988 in Siriraj Hospital. Patients were divided randomly into two groups, 40 patients each, a control and an experiment group. The control group had their skin shaved and the experiment group did not. Data showed no difference in: demography, preoperative admission time, interval between skin preparation and surgery, thickness of subcutaneous tissue, operating time, and suture materials. Shaving of the skin resulted in no alteration in bacteria found on the skin, on the walls of the wound before closing. Stitch abscesses were the only wound infection found in 3 patients in each group. It is concluded that skin shaving, though it did not increase wound infection rate, had no beneficial effect on wound infection in appendectomy. The aim was to study hair removal efficacy, and possible side effects of two commercially available long pulsed diode lasers. The radiant exposure was selected to a value of 35 J/cm2, which is frequently used in the clinic in accordance with manufacturer's recommendations.
                A prospective clinical study was performed on twenty-nine patients with hair color ranging from light brown to black on the upper lip. One half of the upper lip was randomly selected for treatment with the MedioStar laser; the contralateral half of the lip was treated with the LightSheer laser. Three treatments were performed at 6-8 week intervals. Percent hair reduction and acute- and long-term side effects were evaluated after treatment.
                The average hair reductions 6 months after the first treatment were 49% with the MedioStar laser and 48% with the LightSheer laser. No scarring or pigmentary change of the skin was observed after any of the treatments with either laser. However, differences in acute side effects such as degree of erythema and burned hairs were observed.
                No statistically significant differences in hair removal efficacy were observed. These results agree with mathematical modeling, which also offers a method to estimate hair removal efficacy and adverse effects for a range of hair characteristics and laser parameters.
                Copyright 2003 Wiley-Liss, Inc. A modified technique for the Gillies temporal approach without previous hair removal is described. A randomized prospective study of two groups of patients requiring elevation of fractures of the zygomaticomalar complex via this approach with and without hair removal was performed with respect to patients' attitudes and surgeons' assessment. To compare the maternal and neonatal outcomes between perineal shaving and hair cutting in parturients on admission in labor
                Five hundred pregnant women with labor pain and no medical or obstetric complications were selected at random on admission to be assigned into two groups at Rajavithi Hospital from 1st November 2001 to 28th February 2002. Forty two women were excluded because of cesarean section. Two hundred and twenty-seven cases received perineal hair cutting and 231 cases received perineal shaving.
                The gestational age at delivery was statistically significant difference between those receiving perineal hair cutting (39.4 week) comparing with those receiving perineal shaving (39.1 week) (p < 0.05). There was no statistically significant difference in 2 groups for puerperal morbidity, perineal wound infection and dehiscence. There were no neonatal infection and puerperal infection in both groups, where as both accoucheurs and perineorrhaphy operators were more satisfied the perineal shaving group than the cutting group (p < 0.001).
                Perineal shaving or hair cutting on admission in labor had no statistical significant difference effect on the perineal wound infection and dehiscence, neonatal infection, puerperal morbidity and infection. Two types of pre-operative skin preparation were compared in a prospective randomized study conducted on 100 patients undergoing elective surgery: 51 patients were shaven (group I) and 49 were prepared with a depilatory agent. In all cases skin preparation was performed on the eve of the operation. Bacterial density, measured immediately before surgery by application of a contact agar preparation was 493 +/- 928 CFU in group I and 386 +/- 670 CFU in group II (NS). Bacterial density was less than 25 CFU in a significantly greater number of group II patients (P less than 0.01). On the second postoperative day, the number of scars without any sign of sepsis was significantly greater in group II patients (P less than 0.05). In addition, the depilatory agent proved bactericidal against 3 pathogenic strains (S. aureus, Pseudomonas aeruginosa and E. coli). Depilation with a chemical agent seems to be a satisfactory method of pre-operative skin preparation. It is more rapid than shaving, it can be applied to areas not easily accessible to razors, and it can often be carried out by the patient himself. Promising clinical results have been obtained with the normal mode ruby laser for removal of unwanted hair. Melanin within the hair follicles is thought to act as target for the ruby laser pulses, whereas epidermal melanin is thought to be a competitive chromophore, responsible for potential side effects. This study aimed (i) to objectify postoperative changes in skin pigmentation and texture and (ii) to evaluate the importance of variations in preoperative skin pigmentation for the development of side effects 12 weeks after 1 treatment with the normal-mode ruby laser. A total of 17 volunteers (skin types I-IV) were laser-treated in the hairy pubic region (n = 51 test areas). A shaved test area served as control. Skin reflectance spectroscopical measurements, 3-dimensional surface contour analysis and ultrasonography objectified postoperative changes in skin pigmentation and texture. Blinded clinical assessments revealed postoperative hyperpigmentation (2% of test areas) and hypopigmentation (10%), whereas no textural changes were seen. Reflectance spectroscopically-determined pigmentary changes depended on the degree of preoperative skin pigmentation, fairly pigmented skin types experiencing subclinical hyperpigmentation and darkly pigmented skin types experiencing subclinical hypopigmentation. Three-dimensional surface profilometry documented similar pre- and postoperative surface contour parameters, indicating that the skin surface texture is preserved after laser exposure. Ultrasonography revealed similar skin thicknesses in laser-exposed and untreated control areas. It is concluded that normal-mode ruby laser treatment is safe for hair removal in skin types I-IV.
Whilst this review found no statistically significant effect on SSI rates of hair removal insufficient numbers of people have been involved in this research to allow confidence in a conclusion. When it is necessary to remove hair, the existing evidence suggests that clippers are associated with fewer SSIs than razors. There was no significant difference in SSI rates between depilatory creams and shaving, or between shaving or clipping the day before surgery or on the day of surgery however studies were small and more research is needed.