Oh Won-Oak, Yeom Insun, Kim Dong-Seok, Park Eun-Kyung, Shim Kyu-Won
Department of Pediatric Neurosurgery, Severance Hospital, Seoul, South Korea.
Pediatr Neurosurg. 2018;53(1):18-23. doi: 10.1159/000481437. Epub 2017 Oct 27.
Cranial surgical site infection is a significant cause of morbidity and mortality in hospitals. Preoperative hair shaving for cranial neurosurgical procedures is performed traditionally in an attempt to protect patients against complications from infections at cranial surgical sites. However, preoperative shaving of surgical incision sites using traditional surgical blades without properly washing the head after surgery can cause infections at surgical sites. Therefore, a rapid protocol in which the scalp remains unshaven and absorbable sutures are used for scalp closure with early postoperative shampooing is examined in this study.
A retrospective comparative study was conducted from January 2008 to December 2012. A total of 2,641 patients who underwent unshaven cranial surgery with absorbable sutures for scalp closure were enrolled in this study. Data of 1,882 patients who underwent surgery with the traditional protocol from January 2005 to December 2007 were also analyzed for comparison.
Of 2,641 patients who underwent cranial surgery with the rapid protocol, all but 2 (0.07%) patients experienced satisfactory wound healing. Of 1,882 patients who underwent cranial surgery with the traditional protocol, 3 patients (0.15%) had infections. Each infection occurred at the superficial incisional surgical site.
Unshaven cranial surgery using absorbable sutures for scalp closure with early postoperative shampooing is safe and effective in the cranial neurosurgery setting. This protocol has a positive psychological effect. It can help patients accept neurosurgical procedures and improve their self-image after the operation.
颅脑手术部位感染是医院发病和死亡的重要原因。传统上,颅脑神经外科手术术前会进行剃发,试图保护患者免受颅脑手术部位感染并发症的影响。然而,使用传统手术刀片术前剃除手术切口部位毛发,术后未对头进行适当清洗,可能导致手术部位感染。因此,本研究探讨了一种快速方案,即头皮不剃发,使用可吸收缝线缝合头皮,并在术后早期洗头。
2008年1月至2012年12月进行了一项回顾性对照研究。本研究纳入了2641例行不剃发颅脑手术并使用可吸收缝线缝合头皮的患者。还分析了2005年1月至2007年12月采用传统方案进行手术的1882例患者的数据进行比较。
在2641例行快速方案颅脑手术的患者中,除2例(0.07%)外,所有患者伤口愈合良好。在1882例行传统方案颅脑手术的患者中,有3例(0.15%)发生感染。每例感染均发生在手术切口浅表部位。
在颅脑神经外科手术中,不剃发颅脑手术使用可吸收缝线缝合头皮并在术后早期洗头是安全有效的。该方案具有积极的心理效应。它可以帮助患者接受神经外科手术,并改善术后自我形象。