West China School of Nursing, Sichuan University/Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Department of Orthopaedic Surgery, Affiliated Hospital of Chengdu University, Chengdu, China.
Int J Nurs Stud. 2022 Jul;131:104240. doi: 10.1016/j.ijnurstu.2022.104240. Epub 2022 Apr 2.
To evaluate the effectiveness of preoperative shaving and postoperative shampooing on the infection rate in neurosurgery.
Meta-analysis.
We conducted a search of the Embase, CINAHL, Scopus and PubMed databases up until February 1, 2022. Comparative studies were included. No language restrictions were applied.
Original articles that compared the infection rate of patients who had their hair shaved before neurosurgery to the infection rate of unshaven patients were included. Original articles comparing the infection rates of patients whose hair was early postoperative shampooing versus patients whose hair was not shampooed after neurosurgery were also included. The risk of bias was also evaluated using the Newcastle-Ottawa quality assessment scale by two authors independently. The meta-analyses were performed using Review Manager software (RevMan 5.3; Cochrane Collaboration). The odds ratios (ORs) and 95% confidence intervals (CIs) were assessed for dichotomous data (infection rate). The heterogeneity of the included studies was assessed using the I statistic (ranging from 0 to 100%).
A total of 3451 studies were identified by searching the PubMed, Scopus, CINAHL and Embase databases. Fourteen studies met the inclusion criteria, however two studies did not provide data suitable for meta-analysis. Twelve studies were included in the review. Two historical control studies, four prospective studies, one clinical trial and five retrospective studies were identified. There were 4583 patients whose hair was not shaved and 4295 patients whose hair was shaved. Among them, there were 3874 patients whose hair was unshaved and was early postoperative shampooing. No significant difference in the infection rate was found between the unshaved group and shaved group (OR: 0.86, 95% CI [0.62, 1.19], P = 0.85, I = 0%). A significant difference in the infection rates in shunt surgery patients was found between the unshaved group and shaved group (OR: 0.43, 95% CI [0.19, 0.99], P = 0.89, I = 0%). No significant difference was found between the unshaved with early shampooing group and the shaved group (OR: 0.82, 95% CI [0.48, 1.41], P = 0.80, I = 0%).
Hair preservation before neurosurgery and early shampooing after neurosurgery did not increase the infection rate.
评估神经外科术前剃发和术后洗发对感染率的影响。
荟萃分析。
我们对 Embase、CINAHL、Scopus 和 PubMed 数据库进行了检索，检索时间截至 2022 年 2 月 1 日。纳入了比较研究。未对语言进行限制。
纳入了比较神经外科术前剃发患者与未剃发患者感染率的原始文章，以及比较术后早期洗发患者与未洗发患者感染率的原始文章。两名作者独立使用纽卡斯尔-渥太华质量评估量表评估了偏倚风险。使用 Review Manager 软件（RevMan 5.3；Cochrane 协作网）进行荟萃分析。使用二项数据（感染率）评估优势比（OR）和 95%置信区间（CI）。纳入研究的异质性使用 I ² 统计量（0 至 100%）进行评估。
通过搜索 PubMed、Scopus、CINAHL 和 Embase 数据库，共确定了 3451 项研究。有 14 项研究符合纳入标准，但有 2 项研究未提供适合荟萃分析的数据。共纳入 12 项研究。确定了 2 项历史对照研究、4 项前瞻性研究、1 项临床试验和 5 项回顾性研究。有 4583 名患者未剃发，4295 名患者剃发。其中，有 3874 名未剃发且术后早期洗发的患者。未剃发组和剃发组的感染率无显著差异（OR：0.86，95%CI [0.62，1.19]，P=0.85，I²=0%）。分流手术患者中，未剃发组和剃发组的感染率有显著差异（OR：0.43，95%CI [0.19，0.99]，P=0.89，I²=0%）。未剃发且早期洗发组与剃发组的感染率无显著差异（OR：0.82，95%CI [0.48，1.41]，P=0.80，I²=0%）。
神经外科术前保留头发和术后早期洗发不会增加感染率。
