Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA.
J Neurosci Nurs. 2012 Jun;44(3):149-56. doi: 10.1097/JNN.0b013e31825106d2.
Preoperative scalp shaving has been a well-established practice among neurosurgeons based on the belief that hair removal prevents postoperative infections. Apart from aiding in improved visualization of the incision line, ease of closure, and dressing application, there are concerns that the presence of hair at the surgical site may interfere with the surgical procedure. Preoperative scalp shaving is a controversial practice, and many neurosurgeons are moving toward not removing any hair or clipping minimal hair along the incision line rather than shaving the scalp. The following is a systematic review of articles related to preoperative scalp shaving before cranial surgeries and the implications for postoperative wound infections. Eighteen articles were identified as potentially relevant based on the search criteria. These articles were selected based on the inclusion and exclusion criteria to provide concise background information and an explanation of scalp-shaving practices in neurosurgery leading to the clinical question posed. An evidence table was compiled to organize the study data and identify key points. The review brings strong evidence that preoperative scalp shaving does not confer any benefit against postoperative wound infection and, paradoxically, may lead to higher rates of infection. Because hair removal neither contributes benefits to the surgery itself nor decreases the risk of wound infection but has considerable cosmetic value for the patient, many of the authors recommended that cranial surgeries should be done without hair shaving.
术前头皮剃毛在神经外科医生中已经是一种既定的做法，其依据是去除毛发可以预防术后感染。除了有助于更好地观察切口线、便于缝合和敷料应用外，人们还担心手术部位的毛发可能会干扰手术过程。术前头皮剃毛是一种有争议的做法，许多神经外科医生正在转向不剃除任何毛发或仅沿切口线剪去少量毛发，而不是剃光头。以下是对与颅前手术前头皮剃毛相关的文章进行的系统回顾，以及对术后伤口感染的影响。根据搜索标准，确定了 18 篇可能相关的文章。这些文章是根据纳入和排除标准选择的，以提供简明的背景信息和神经外科头皮剃毛实践的解释，从而引出提出的临床问题。编制了一个证据表来组织研究数据并确定关键点。该综述有力地证明了术前头皮剃毛并不能预防术后伤口感染，反而可能导致更高的感染率。由于去除毛发既不能对手术本身带来益处，也不能降低感染风险，但对患者有相当大的美容价值，因此许多作者建议在不进行头发剃除的情况下进行颅面手术。
