Shaving before surgery raises infection risk

Shaving patients before surgery increases the risk of surgical site infections, the World Health Organisation (WHO) has warned. PHOTO| FILE

Shaving patients before surgery increases the risk of surgical site infections, the World Health Organisation (WHO) has warned, and urged health workers to avoid shaving surgical sites with a razor blade.

The WHO recommends that hair not be removed, unless it will interfere with the surgery. Where hair removal is necessary, the global health body recommends use of electrical clippers.

“Shaving is strongly discouraged and should be avoided. If necessary, hair should be removed only with a clipper and not a razor blade,” says the international health agency, in the latest update of guidelines for prevention of surgical site infections.

Shaving with a razor blade causes microscopic nicks in the skin that can become bacterial breeding grounds. Surgical site infections are caused by bacteria that get in through incisions made during and after surgery.

They are a leading cause of complications, accounting for nearly one out of five healthcare-associated infections and thousands of deaths annually.

One study by the Centers for Disease Control and Prevention in the US, showed that patients with shaved incision sites had a six per cent rate of infection, compared with a rate of less than one per cent among patients whose hair was removed with clippers.

PREVENTION

“In low- and middle-income countries, more than one in 10 patients who undergo surgery are infected in the process. Surgical site infections threaten the lives of millions of patients each year and contribute to the spread of antibiotic resistance,” warns the WHO, adding that in Africa, up to 20 per cent of women who give birth via Caesarian section get a wound infection, compromising their health, and their ability to care for their babies.

Instead of shaving, the guidelines recommend simple precautions like ensuring patients take a bath or shower before surgery; ensuring surgical teams use the best possible methods to clean their hands (scrubbing hands with antimicrobial soap and water or alcohol-based hand rub before putting on gloves for surgery); advice on when to give antibiotics to prevent infections; best disinfectants (use of alcohol-based antiseptic solutions based on chlorhexidine gluconate) for surgical site preparation before incision (cutting into skin), and which sutures (stitches) doctors should use.

“Hygienic hand rub refers to the treatment of hands with an antiseptic to reduce the transient flora without necessarily affecting the resident skin flora. Such antiseptics often have persistent antimicrobial activity. No one should get sick while seeking or receiving care," said Marie-Paule Kieny, the assistant director-general for health systems and innovation.

"Preventing surgical infections requires a range of preventive measures. These guidelines are an invaluable tool for protecting patients," she added. The guidelines based on the strength of available scientific evidence, can be adapted to local circumstances including cost and resource implications and patient values and preferences.