INFECTION CONTROL MANUAL
Chapter 39
Pre-Operative Shaving Policy
Version 5
Document Summary
This policy provides guidance for the appropriate actions and responsibilities
for the management of pre-operative patients with regard to hair removal.
prior to surgery.
DOCUMENT NUMBER
APPROVING COMMITTEE
DATE APPROVED
DATE IMPLEMENTED
NEXT REVIEW DATE
ACCOUNTABLE DIRECTOR
POLICY AUTHOR
TARGET AUDENCE
KEY WORDS
STHK0050
Patient Safety Council
10 September 2014
1 November 2014
1 November 2017
Sue Redfern, Director of Nursing, Midwifery &
Governance
Karen Allen, Director of Infection Prevention &
Control
All clinical staff
Pre-operative shaving, clippers, depilatory
cream.
Important Note:
The Intranet version of this document is the only version that is maintained.
Any printed copies should therefore be viewed as “uncontrolled” and, as such,
may not necessarily contain the latest updates and amendments
Infection Control Manual - Chapter 39 Pre-operative shaving policy – Version 5 (clinical)
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Issue Date: 1st November 2014
Policy Reference number: STHK50
St Helens & Knowsley Teaching Hospitals NHS Trust
Document Version History
Date
Version
1 December 2003
1
1 December 2006
2
1 December 2008
3
1 November 2011
4
1 November 2014
5
1 November 2017
Review
Date
Summary of key changes
Format changed.
Contact details updated.
Page 6: References added.
Format changed
Author
Designation
Service
Manager
Infection Prevention
& Control
Service
Manager
Infection Prevention
& Control
Service
Manager
Infection Prevention
& Control
Service
Manager
Infection Prevention
& Control
DIPC
Lead Nurse Infection
prevention & Control
Infection Control Manual - Chapter 39 Pre-operative shaving policy – Version 5 (clinical)
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Issue Date: 1st November 2014
Policy Reference number: STHK50
St Helens & Knowsley Teaching Hospitals NHS Trust
CONTENTS
Item No.
1.
2.
3.
4.
5.
6.
6.1
6.2
6.3
7.
8.
8.1.
8.2.
9.
10.
11.
Subject
Scope
Introduction
Statement of Intent
Definitions
Duties, Accountabilities and Responsibilities
Process
Evidence
Recommendations
Further advice
Training
Monitoring compliance
Key Performance Indicators of the Policy
Performance Management of the Policy
References and Bibliography
Related Policies and Procedures
Equality analysis
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Page No.
4
4
4
4
4
4
4
5
5
5
5
5
5
5
6
6
St Helens & Knowsley Teaching Hospitals NHS Trust
1. Scope
This policy applies to all clinical staff within St Helens and Knowsley Teaching Hospitals
NHS Trust:

to advise staff of the infection risks associated with pre-operative shaving.

to ensure appropriate methods of hair removal prior to surgery.

to prevent the patient contracting an surgical site infection related to shaving.
2. Introduction
Hair is no more heavily colonised with microbial flora than skin. Hair, with its hard
chitinous surface, is easier to clean with skin preparation than the skin on which it grows.
Criteria for hair removal should therefore be based on the need to view or access the
operation site rather than removal of bacteria.
3. Statement of Intent
The objective of the policy is to avoid unnecessary risk of surgical site infection due to preoperative shaving.
4. Definitions
Pre-operative care is the preparation and management of a patient prior to surgery.
5. Duties Accountabilities and Responsibilities
For full details of infection control responsibilities see Infection Control Policy, Chapter 28B
Infection Control Manual.
5.1. Staff
It is the responsibility of all clinical staff to:
 be aware of the current guidelines.
 put these guidelines into practice.
 bring to the attention of the Unit Manager or Infection Prevention and Control Team
any problems in applying these guidelines
Breaches of this policy may lead to disciplinary action being taken against the individual.
5.2. Unit managers (person in charge of a ward or department) must ensure that
 The policy is readily accessible to all staff.
 The required facilities and equipment are available to enable compliance with the
policies.
 All staff within their area of responsibility have received training in the appropriate
procedures with respect to infection control.
6. Process
6.1 Evidence
The Centre of Disease Control Atlanta1 (2001) provides recommendations on preoperative hair removal as does the report from the Hospital Infection Society Working
Group on Infection Control in Operating Theatres (2002).2 Both strongly recommend
avoidance of hair removal if at all possible. A Cochrane Review3 (2006) found no
difference in surgical site infections among patients who have had hair removed prior to
surgery and those who have not. If it is necessary to remove hair then both clipping and
depilatory creams results in fewer surgical site infections than shaving using a razor.
Infection Control Manual - Chapter 39 Pre-operative shaving policy – Version 5 (clinical)
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Issue Date: 1st November 2014
Policy Reference number: STHK50
St Helens & Knowsley Teaching Hospitals NHS Trust
6.2 Recommendations:
 Avoid shaving if at all possible.
 If necessary, use single-use clippers or depilatory cream on the day of surgery.
N.B. Some patients may have skin sensitivity to depilatory creams.
 Patients must not be asked to shave at home prior to admission.
6.3 Further advice
For further advice and guidance please contact:
Lead Nurse, Infection Prevention & Control
Ext. 1193
Clinical Nurse Specialists, Infection Prevention & Control
Ext. 2452/1384
Consultant Microbiologists
Ext. 1834/1836/1622 or duty Microbiologist via switchboard out of hours
7. Training
Training required to fulfil this policy will be provided in accordance with the Trust’s
Induction Mandatory and Risk Management Training Policy - Training Needs Analysis.
8. Monitoring compliance with this document
8.1 Key performance Indicators of the Policy
Describe Key Performance Frequency
Indicators (KPIs)
Review
of Lead
None specific to this policy (see
related Infection Control Manual
chapters) referenced in section
10.
8.2 Performance Management of the Policy
Aspect
of Monitoring Individual
Frequency
compliance
method
responsible of
the
or
for
the monitoring
effectiveness
monitoring activity
being
monitored
N/A
N/A
N/A
N/A
Group
/
committee
which will
receive the
findings /
monitoring
report
N/A
Group
/
committee /
individual
responsible
for
ensuring
that
the
actions are
completed
N/A
9. References/ bibliography
References
1. Nichols RL. Preventing Surgical Site Infections: A Surgeon's Perspective 2001.
Emerging Infectious Disease: 7; 2. Mar–Apr 2001.
http://www.cdc.gov/ncidod/eid/vol7no2/pdfs/nichols.pdf
Infection Control Manual - Chapter 39 Pre-operative shaving policy – Version 5 (clinical)
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Issue Date: 1st November 2014
Policy Reference number: STHK50
St Helens & Knowsley Teaching Hospitals NHS Trust
2. Behaviours and Rituals in the Operating Theatre: A report from the Hospital Infection
Society Working Group on Infection Control in the Operating Theatres.
http://www.his.org.uk/_db/_documents/Rituals-02.doc
3. Tanner J, Woodings D, Moncaster K. Preoperative hair removal to reduce surgical site
infection. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD004122.
DOI: 10.1002/14651858.CD004122.pub3
http://www2.cochrane.org/reviews/en/ab004122.html
4 NICE guidelines. October 2008. Prevention and treatment of surgical site infection
10. Related trust policy/procedures
Associated Infection Control Manual chapters:
Chapter 21
Hand decontamination policy
11. Equality analysis
Please refer to the overarching document which covers all chapters of the Infection Control
Manual. http://nww.sthk.nhs.uk/MANAGE/library/documents/EqualityAnalysisforICM.pdf
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Issue Date: 1st November 2014
Policy Reference number: STHK50