Technical Note Nonshaved cranial surgery in black Africans: a short-term prospective preliminary study Amos Olufemi Adeleye, MBBS, FWACS 4 , Kayode G. Olowookere, MBBS Division of Neurosurgery, Department of Surgery, Lagos State University Teaching Hospital, P.M.B. 21105 Ikeja, Nigeria Received 19 December 2006; accepted 13 February 2007 Abstract Background: Many studies on white populations have shown the absence of any scientific, or even beneficial, basis for the traditional preoperative ritual of shaving the operative field. We were not able to lay our hands on any document regarding this subject on any black African population. Methods: We prospectively performed 17 cranial procedures in nonshaved fields in 15 selected black Africans in the Lagos State University Teaching Hospital, Ikeja, Nigeria. Results: There was no serious complication recorded over a short-term follow-up of 2 to 6 months. The short, curly, crimpy, and densely knotted black African scalp hairs however did pose some unique perioperative challenges to us. Conclusions: Nonshaved cranial surgery, as in whites/Asians, can also be safely carried out in black Africans. This however demands some attention to details in the perioperative care of the incision sites. We found this caveat to be particularly more imperative in black Africans because of their unique anthropological scalp hair characteristics. D 2008 Elsevier Inc. All rights reserved. Keywords: Nonshaved cranial surgery; Black Africans; Nigeria 1. Introduction Preoperative shaving of hair-bearing surgical incision sites is a long established practice aimed, in conjunction with other preoperative rituals, at controlling infective complications of surgeries. There are a growing number of contemporary studies, however, showing that there is no scientific basis to this practice [15,22,23], and that elective and emergency cranial surgeries are safely carried out in nonshaved fields [2,7,9,12,15,18,21]. Some workers have actually documented reduced rates of wound infections in surgeries in shaveless groups [5,6,17]. We pioneered a new neurosurgical service in a young teaching hospital, the Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria, in January 2005 and selected some uncomplicated cranial procedures for shave- less surgeries. This is a preliminary short-term outcome of our prospective survey in which we seek to show the prospects and the challenges of nonshaved cranial surgery in a black African population. It appears that this is the first document on this subject in our patient population. 2. Materials and methods Over a 7-month period from July 1, 2005, to January 30, 2006, all cranial surgeries in hair-bearing scalps of patients with no confounding comorbidities were carried out in nonshaved fields. These included emergency and elective cranial procedures. For the sake of this analysis, we looked at the patients’ demographics (hospital number, age, sex, and date of procedures); nature of surgery (emergency or elective); classification of the procedures: minor (scalp incisions/excision of scalp masses with no skull opening), moderate (ventricular shunting, minimal skull openings [burr-holes placements]), and major (repair of large ence- phaloceles and major intracranial works); duration of postoperative hospital stay and time of operative stitches removal in days; duration of perioperative antimicrobial prophylaxis; postoperative complications, infectious and others; and lengths of follow-up. 0090-3019/$ – see front matter D 2008 Elsevier Inc. All rights reserved. doi:10.1016/j.surneu.2007.02.046 4 Corresponding author. Department of Neurosurgery, Hadassah- Hebrew University Medical Centre, POB 12000, Ein Kerem, Jerusalem 91120, Israel. E-mail address: femdoy@yahoo.com (A.O. Adeleye). Surgical Neurology 69 (2008) 69 – 72 www.surgicalneurology-online.com