Tariq Muhammad, Raza Rizvi.
Cranial Neurosurgery Without Removing Scalp Hairs.
J Surg Pak Jan ;20(3):96-9.

Objective: To find out rate of wound infection, difficulties encountered and patient’s satisfaction with scalp hair preservation during cranial surgeries. Study design: Descriptive case series. Place & Duration of study: Ziauddin University Hospital Karachi Clifton campus, from January 2013 to June 2014. Methodology: The hair cleaning and scrubbing procedure was done at the time of surgery with pyodine solution. Scalp shaving was not done. Routine surgical incision was made. Surgical wound was closed with a standard technique. Dressing was not applied. Exclusive traumatic lacerated extensive scalp wounds and cranioplasties cases were also included. Scalp hairs were shampooed postoperatively after 48 hours. The wounds were checked at outpatient follow-up on week 2, week 4 and then monthly for at least 3 months following discharge. Results: A total of 86 patients were operated without shaving scalp hairs. There were 55 females and 31 male patients. Average age was 45.5 year. The procedures included were craniotomies for traumatic intracranial hematomas, tumors, hypertensive intracerebral hematomas, burr hole procedures for chronic subdural hematomas and placement of ventriculoperitoneal shunts. Technical difficulties were posed by very short and coarse hairs. Infection rate was less than 0.86%. All of the patients were happy and satisfied with their appearance after surgery. Conclusions: Scalp hair preservation in cranial surgeries neither increased risk of postoperative wound infection nor made surgery difficult. The technique resulted in greater patients’ satisfaction and good cosmetic outcome.

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