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The preoperative skin shave in neurosurgery: is it justified?

Shaving the scalp prior to surgery is a very common practice. Out of 105 cases operated upon without skin shave at the Royal London Hospital, only one became infected (0.95%). A search into the history of aseptic surgery shows that there are no scientific grounds for the practice of shaving. An examination of contemporary practices worldwide shows that there is a greater realization that preoperative skin shaving does not confer any benefit against postoperative wound infection and that, paradoxically, it may lead to higher rates of wound infection due to the epidermal injury that it inflicts.