Cranial Neurosurgery without Hair Removal and Shampoo Care: Retrospective Analysis of 450 Cases

Abstract

Background Trichotomy is a standard procedure in neurosurgery that aims at reducing infection rates. In children, psychological consequences associated to the whole head's hair removal are remarkable. Over the past twenty years the risk of infection associated to neurosurgical procedures has been thoroughly analyzed. Two negative consequences are associated to trichotomy: the loss of the natural defences offered by hair, and multiple skin lesions that increase bacterial growth. Our hospital established a protocol consisting of head washes before and after cranial neurosurgery with antiseptic shampoo, followed by daily washes with neutrum soap when the patient is discharged ("shampoo care"). Goal. To assess infection rate in a population of children who underwent cranial neurosurgery without hair removal. Methods Retrospective analysis of clinical records of children undergoing cranial neurosurgery with "shampoo care" during one year. Results 450 children were included. 5.55% of them had a wound complication, with only two cases of infection (0.4%). Available literature was revised to assess the effectiveness of our protocol. Wound complication and infections rates found in our experience were lower than those reported in patients treated with a standard trichotomy. Discussion Cranial neurosurgery without hair removal and "shampoo care" is an effective method to reduce infection rates. This results in a shorter hospital stay, better self-esteem and improved quality of life when the child goes back to family life and school.