It is a well-known and commonly-taught factoid of medical practice that you cannot make human hair sterile, hence the omnipresent shaving thereof in contemplation of any surgery.
I do not need a cite to convince me that the College of Surgeons or the AMA or any other authoritative body considers it to be impossible to sterilize hair or to create a sterile area of a hairy patch of skin without shaving the hair off of it.
I don’t see any reason it should be so, however. Hair itself is not living tissue and exudes nothing; at its root it is anchored in skin in a place that continues to exist when the hair is sliced off or plucked out. Hair seems ill-equipped to act like a wick, conveying material from the follicle upward and outward at any rapid rate, and meanwhile if there were any unsanitary substances there that could pollute a sterile field, seems like they would be bubbling or oozing to the surface of shaved skin — at the most it seems like it would be a matter of degree.
As for the hair itself, what would render it impervious to disinfectants and antiseptics? I would think a good dose of betadine or alcohol would generate a sterile hair in much the same fashion as it generates a patch of sterile skin.
There is skin in areas that would seem far from conducive to more than momentary sterilization, such as the perineum, and yet when it is necessary to do surgery there, that doesn’t seem to constitute a problem.
Therefore… cite? Anyone got any actual solid evidence to back up the perennial claim that shaving is necessary for sterility purposes? Or is it all just tradition and convention?
I think it is more from the standpoint of:
keeping the hair out of any wound site being worked on - hair likes squidging around when it is coated with blood and guk, and you really do not want it being sewn into the incision
making it easier to actually suture up the incision. Ever tried teddybear surgery? when you fix a seam it takes a lot of care to not suck the fibers into the seamline when you are sewing it up so you can fluff it out and make the seam less visible.
They will frequently staple head wounds shut without shaving back lots of hair …
Another thing on the hair-shaving is that foreign bodies, like bits of hair, within the body can become problematic. Things can get calcified or whatever and can cause problems later on (irritation of tissue can cause a number of ‘reactions’ in that area). Usually, but not always, there is not much of a problem, but ‘tradition’ says to do it because it is worth the while to do so. This may not be the biggest reason, but it is one of them
Or so I have been told by numerous surgeons I’ve worked with along with a distant memory or two from school.
OTOH, shaving with a razor causes small nicks to the skin that may increase the risk of surgical site infections (I guess by seeding the skin with bacteria before you even start). Clipping (or using depilatory cream) works just as well and does not have this risk.
Patients’ eyelashes used to be cut before cataract surgery. Nowadays they don’t bother, although they smear the eyelashes and the whole around-the-eye area (adnexa if you want to be fancy) with betadine prior. So there is at least one example where it’s not standard of practice to depilate.
I’ve seen where they place a large peel and stick sheet of plastic that’s infused with Betadine over the surgical area and they cut right through it. Keeps the entire area sterile right up to the edge of the incision.
