Nonshaved cranial neurosurgery

BACKGROUND: Preoperative shaving for cranial neurosurgical procedures is still recommended in textbooks. There are reports demonstrating the success of nonshaved surgery. The objective of this study was to compare the surgical infection rate of cranial neurosurgical procedures with two different scalp preparations: shaved or nonshaved. METHODS: Clinical trials of nonshaved scalp preparation were performed in non-emergency cranial neurosurgical procedures at Songklanagarind Hospital from August 1994 to December 1996. Patients were entered in the nonshaved group using the following exclusion criteria: immunocompromised host, presence of infectious diseases, surgery with foreign material insertion, multiple operations within 1 month, and presence of traumatic wound around the operative site. Patients who survived less than 1 month after surgery were excluded except in cases where death resulted from intracranial infection. RESULTS: During the 29-month period, 225 of 1,244 cranial neurosurgical procedures were selected for study. Ages ranged from 4 to 86 years. Brain tumors were encountered in 57%. In the nonshaved group, there were 89 procedures (80 cases), compared with 136 procedures (123 cases) in the shaved group. Surgical infection rates were 3.37% and 5.88%, respectively (p>0.05). CONCLUSIONS: Nonshaved scalp preparation is recommended for nonemergency cranial neurosurgical procedures.