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Hair Removal Policies in Clean Surgery: Systematic Review of Randomized, Controlled Trials

Published online by Cambridge University Press:  21 June 2016

B. S. Niël-Weise ,
J. C. Wille  and
P. J. van den Broek
B. S. Niël-Weise*
Affiliation:
Dutch Working Party on Infection Prevention, Leiden, the Netherlands
J. C. Wille
Affiliation:
Dutch Institute for Healthcare Improvement, Utrecht, the Netherlands
P. J. van den Broek
Affiliation:
Department of Infectious Diseases, Leiden University Hospital, Leiden, the Netherlands
*
C9-43 P. 0. Box 9600, 2300 RC Leiden, the Netherlands, [email protected]
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Abstract

Objective:

To determine whether certain hair removal policies are better than others to prevent surgical-site infections in patients undergoing clean surgery.

Methods:

Publications were retrieved by a systematic search of Medline, the Cochrane Library, and EMBASE up to February 2005. Additionally, the reference lists of all identified trials were examined. All randomized trials, quasi-randomized trials, and systematic reviews or meta-analyses of randomized or quasi-randomized trials comparing hair removal policies in clean surgery were selected. Trials involving patients undergoing cranial neurosurgery were excluded. Two reviewers independently assessed trial quality and extracted data. Disagreements were resolved by discussion with a third reviewer. Data from the original publications were used to calculate the relative risk or risk difference of surgical-site infection. Data for similar outcomes were combined in the analysis, where appropriate, with the use of a random effects model.

Results:

Four trials were included in the review. No eligible systematic review or meta-analysis of randomized or quasi-randomized trials was found. The quality of the trials and how they were reported were generally unsatisfactory. Evidence regarding whether preoperative hair removal has any effect was inconclusive. When hair removal was considered necessary, evidence about the best time for removal was inconclusive. There was some evidence that hair removal by clipper is superior to removal by razor.

Conclusions:

Because of insufficient evidence as a basis for recommendations, the practical consequences for ward management were essential when the Dutch Working Party on Infection Prevention formulated its recommendations for hair removal policies. Large randomized, controlled trials are needed to determine the optimal policy for preoperative hair removal.

Type
Orginal Article
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 12 , December 2005 , pp. 923 - 928
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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