Division of Neurosurgery, Sendai Shimin Hospital, 4107-7 Nagatoshi-cho, Satsumasendai City, Kagoshima 895-0005, Japan.
J Craniomaxillofac Surg. 2009 Dec;37(8):477-80. doi: 10.1016/j.jcms.2009.06.003. Epub 2009 Jul 14.
Based on a series of 632 patients who underwent craniotomy without head shaving, we report the efficacy and safety of our simplified procedure and document the usefulness of the electrosurgical scalpel.
After brushing a chlorhexidine-alcohol solution onto the craniotomy site, the hair was parted from the incision line and fixed with adhesive paper drapes. In recent cases, electrosurgical scalpels were used for scalp- and subcutaneous dissection. At the end of surgery, the wound was closed in the usual manner, taking care that no hair was in the wound and the hair and wound were rinsed with clean water in the operating room. We did not apply disinfectant for postoperative wound care, rather, the hair was shampooed on the 2nd, 4th, and 6th postoperative day.
Among 632 patients who underwent cranial surgery without head shaving, only 7 (1.1%) developed postoperative wound infections. None of the 34 patients who underwent craniotomy using the electrosurgical scalpel developed wound infections.
Our simplified cranial surgery without head shaving does not increase the risk of wound infection. Because the use of the electrosurgical scalpel for skin and soft tissue dissection minimizes bleeding, the probability of wound infection appears to be reduced.
我们报告了在 632 例无需剃发的开颅手术中,简化手术流程的疗效和安全性,并证明电手术刀的有效性。
在头皮切口处涂抹洗必泰酒精溶液后,将头发从前额到切口线分开,并使用粘性纸帘固定。在最近的病例中,使用电手术刀进行头皮和皮下组织解剖。手术结束时,以常规方式关闭伤口,注意伤口内无毛发,并用手术室的清洁水冲洗毛发和伤口。我们不使用消毒剂进行术后伤口护理,而是在术后第 2、4、6 天用洗发水清洗头发。
在 632 例无需剃发的开颅手术患者中,仅 7 例(1.1%)发生术后伤口感染。34 例使用电手术刀进行开颅手术的患者均未发生伤口感染。
我们简化的无需剃发开颅手术不会增加伤口感染的风险。由于电手术刀用于皮肤和软组织解剖可最大程度地减少出血,因此伤口感染的概率似乎降低了。