TY - JOUR
T1 - Clinical Outcomes of Preoperative Hair Clipping versus No Clipping in Cranial Neurosurgery
T2 - A Systematic Review and Meta-Analysis
AU - Kamil, Robert
AU - Dakhel, Sami
AU - Lacuarta, Kenzo
AU - AbdelAlim, Youssef Atef
AU - Sulaj, Erion
AU - Barsch, Jake
AU - Lambert, Alex
AU - Hundal, Jasdeep S.
AU - Jahangiri, Arman
AU - Kreatsoulas, Daniel
AU - Patel, Nitesh
AU - Shah, Ashish
AU - Ivan, Michael E.
AU - Goldstein, Ira
AU - Komotar, Ricardo J.
N1 - Publisher Copyright: © 2025
PY - 2026/2
Y1 - 2026/2
N2 - Objective: This meta-analysis aimed to assess the clinical impact of preoperative hair clipping versus no clipping in cranial neurosurgery, addressing an important element of patient-centered care that balances surgical needs with patient comfort. By examining existing evidence, this study seeks to inform neurosurgical practices on preoperative preparation choices that respect both clinical safety and patient preferences. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews, articles from PubMed, Google Scholar, Embase, Scopus, and ScienceDirect, and studies that included adult patients undergoing cranial surgeries were included for data extraction and analysis. Studies were selected based on the presence of preoperative hair clipping or no clipping as a variable. Only comparative studies evaluating clipping versus no clipping were included, and razor-only or noncomparative hair-removal studies were excluded. The primary outcomes compared between these groups included infection rates, reoperation rates, readmission rates, and postoperative complications. Where available, details of perioperative protocols (preoperative Hibiclens/chlorhexidine showers, intraoperative scalp prep, postoperative antibiotic regimens, wound coverage, and timing of hair washing) were extracted. Results: The analysis of studies (n = 22) revealed a higher infection rate in the clipping group compared to the no-clipped group (3% vs. 2%; 95% confidence interval [CI] 2–5% vs. 1–3%), though this difference was not statistically significant (P = 0.10). Reoperation rates were slightly higher in the no-clipping group than the clipping group (1% vs. 0%; 95% CI 0–3% vs. 0–1%), but this difference was also not statistically significant (P = 0.35). No significant difference in readmission rates was observed between the 2 groups (0% vs. 0%; 95% CI 0–3% vs. 0–1%, P = 0.83). Postoperative complications, primarily wound dehiscence, were comparable between the clipping and no-clipping groups (1% vs. 1%; 95% CI 0–2% vs. 0–3%, P = 0.61). Conclusions: This meta-analysis found no statistically significant differences in infection, reoperation, readmission rates, or postoperative complications between patients undergoing cranial neurosurgery with or without hair clipping. These findings suggest that preoperative hair clipping may not be clinically necessary, allowing patient preference to be incorporated without compromising outcomes. Furthermore, variations in perioperative antiseptic, antibiotic, and wound-care practices highlight the need for standardized reporting in future studies.
AB - Objective: This meta-analysis aimed to assess the clinical impact of preoperative hair clipping versus no clipping in cranial neurosurgery, addressing an important element of patient-centered care that balances surgical needs with patient comfort. By examining existing evidence, this study seeks to inform neurosurgical practices on preoperative preparation choices that respect both clinical safety and patient preferences. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews, articles from PubMed, Google Scholar, Embase, Scopus, and ScienceDirect, and studies that included adult patients undergoing cranial surgeries were included for data extraction and analysis. Studies were selected based on the presence of preoperative hair clipping or no clipping as a variable. Only comparative studies evaluating clipping versus no clipping were included, and razor-only or noncomparative hair-removal studies were excluded. The primary outcomes compared between these groups included infection rates, reoperation rates, readmission rates, and postoperative complications. Where available, details of perioperative protocols (preoperative Hibiclens/chlorhexidine showers, intraoperative scalp prep, postoperative antibiotic regimens, wound coverage, and timing of hair washing) were extracted. Results: The analysis of studies (n = 22) revealed a higher infection rate in the clipping group compared to the no-clipped group (3% vs. 2%; 95% confidence interval [CI] 2–5% vs. 1–3%), though this difference was not statistically significant (P = 0.10). Reoperation rates were slightly higher in the no-clipping group than the clipping group (1% vs. 0%; 95% CI 0–3% vs. 0–1%), but this difference was also not statistically significant (P = 0.35). No significant difference in readmission rates was observed between the 2 groups (0% vs. 0%; 95% CI 0–3% vs. 0–1%, P = 0.83). Postoperative complications, primarily wound dehiscence, were comparable between the clipping and no-clipping groups (1% vs. 1%; 95% CI 0–2% vs. 0–3%, P = 0.61). Conclusions: This meta-analysis found no statistically significant differences in infection, reoperation, readmission rates, or postoperative complications between patients undergoing cranial neurosurgery with or without hair clipping. These findings suggest that preoperative hair clipping may not be clinically necessary, allowing patient preference to be incorporated without compromising outcomes. Furthermore, variations in perioperative antiseptic, antibiotic, and wound-care practices highlight the need for standardized reporting in future studies.
KW - Clipping versus no clipping
KW - Hair clipping
KW - Infection rates
KW - Meta-analysis
KW - Neurosurgery
KW - PRISMA
UR - https://www.scopus.com/pages/publications/105027514610
U2 - 10.1016/j.wneu.2025.124724
DO - 10.1016/j.wneu.2025.124724
M3 - Article
C2 - 41421657
SN - 1878-8750
VL - 206
JO - World Neurosurgery
JF - World Neurosurgery
M1 - 124724
ER -