Changes of the skin barrier and bacterial colonization after hair removal by clipper and by razor
Paper #2997 received 2016.03.31 revised manuscript received 2016.05.27; accepted for publication 2016.05.30; published online 2016.06.14.
Background: Inappropriate hair removal increases the risk of surgical site infections which are associated with a higher morbidity and mortality of surgical patients. Here, the effects of a clipping device and a disposable razor on the skin barrier, microbial burden and surface structure were compared. Methods: Changes in bacterial colonization, transepidermal water loss, antioxidant status and the skin surface structure were investigated on the calves of 12 healthy volunteers. Measurement time points were at baseline (tbase) and 24 hours after hair removal (t24). Results: Both, the disposable razor and the clipper showed a decrease in log colony-forming units count from tbase (mean(tbase) ± standard deviation = 2.6 ± 1.27, median ± standard error = 2.6 ± 0.37) to t24 at prazo r= 0.05 and pclipper = 0.06 respectively. At t24 clipping resulted in a higher reduction of log colony-forming units (mean(t24) = 1.76 ± 0.8, median = 1.69 ± 0.23) compared to the use of the disposable razor (mean(t24) = 1.84 ± 0.85, median = 1.91 ± 0.24). Furthermore, the razor-treated group showed an increase in colony-forming units from t0 to t24, whereas clipping lead to a continuous decrease in colony-forming units from t0 to t24. An enhanced appearance of microlesions and a significant increase of transepidermal water loss after shaving using the disposable razor (p = 0.005) were found indicating skin barrier disruptions. Clipping showed no significant effect on transepidermal water loss. Conclusion: Hair removal using the clipping device results in less disruption of the skin barrier compared to the razor, avoiding the development of microlesions. This could be favorable for the prevention of surgical side infections and postoperative wound management.
1. J. Tanner, D. Woodings, and K. Moncaster, “Preoperative hair removal to reduce surgical site infection,” Cochrane Database of Systematic Reviews, CD004122 (2006).
2. A. J. Mangram, T. C. Horan, M. L. Pearson, L. C. Silver, and W. R. Jarvis, “Guideline for Prevention of Surgical Site Infection,” American Journal of Infection Control 27(2), 97–134 (1999). Crossref
3. B. Lange-Asschenfeldt, D. Marenbach, C. Lang, A. Patzelt, M. Ulrich, A. Maltusch, and J. Lademann, “Distribution of Bacteria in the Epidermal Layers and Hair Follicles of the Human Skin,” Skin Pharmacology and Physiology 24(6), 305–311 (2011). Crossref
4. J. Tanner, K. Moncaster, and D. Woodings “Preoperative hair removal: A systematic review,” J Perioper Pract. 17(3), 118-121, 124-132 (2007).
5. M. Briggs “Principles of closed surgical wound care,” J Wound Care 6(6), 288-292 (1997).
6. P. J. Cruse, and R. Foord “The epidemiology of wound infection. A 10-year prospective study of 62,939 wounds,” Surgical Clinics of North America 60(1), 27-40 1980. Crossref
7. B. S. Niel?Weise, J. C. Wille, and P. J. van den Broek, “Hair Removal Policies in Clean Surgery: Systematic Review of Randomized, Controlled Trials,” Infect Control Hosp Epidemiol 26(12), 923–928 (2005). Crossref
8. R. Seropian, and B. M. Reynolds, “Wound infections after preoperative depilatory versus razor preparation,” The American Journal of Surgery 121(3), 251–254 (1971). Crossref
9. J. M. Shannon, P. Thur de Koos, and W. C. Beck, “Preoperative skin preparation and wound infection,” Inf Surg 5 (1985).
10. G. Mehta, B. Prakash, and S. Karmoker, “Computer assisted analysis of wound infection in neurosurgery,” Journal of Hospital Infection 11(3), 244–252 (1988). Crossref
11. S. F. Mishriki, D. J. W. Law, and P. J. Jeffery, “Factors affecting the incidence of postoperative wound infection,” Journal of Hospital Infection 16(3), 223–230 (1990). Crossref
12. E. Kaya, I. Yetim, A. Dervisoglu, M. Sunbul, and Y. Bek, “Risk Factors for and Effect of a One-Year Surveillance Program on Surgical Site Infection at a University Hospital in Turkey,” Surgical Infections 7(6), 519–526 (2006). Crossref
13. P. Gastmeier, C. Brandt, D. Sohr, R. Babikir, D. Mlageni, F. Daschner, and H. Ruden, “[Surgical site infections in hospitals and outpatient settings. Results of the German nosocomial infection surveillance system (KISS)],” Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz 47(4) 339-344 (2004). Crossref
14. K. B. Kirkland, J. P. Briggs, S. L. Trivette, W. E. Wilkinson, and D. J. Sexton, “The Impact of Surgical?Site Infections in the 1990s: Attributable Mortality, Excess Length of Hospitalization, and Extra Costs,” Infect Control Hosp Epidemiol 20(11), 725–730 (1999). Crossref
15. C. R. McHenry, J. J. Piotrowski, D. Petrinic, and M. A. Malangoni, “Determinants of Mortality for Necrotizing Soft-Tissue Infections,” Annals of Surgery 221(5), 558–565 (1995). Crossref
16. C. D. Owens, and K. Stoessel, “Surgical site infections: epidemiology, microbiology and prevention,” Journal of Hospital Infection 70, 3–10 (2008). Crossref
17. J. W. Alexander, “The Influence of Hair-Removal Methods on Wound Infections,” Archives of Surgery 118(3), 347–352 (1983).
18. I. Kjønniksen, B. M. Andersen, V. G. Søndenaa, and L. Segadal, “Preoperative Hair Removal—a Systematic Literature Review,” AORN Journal 75(5), 928–940 (2002). Crossref
19. G.B. Orsi, F. Ferraro, and C. Franchi, “[Preoperative hair removal review],” Annali di igiene: medicina preventiva e di comunita 17(5), 401-412 (2005).
20. I. Uçkay, P. Hoffmeyer, D. Lew, and D. Pittet, “Prevention of surgical site infections in orthopaedic surgery and bone trauma: state-of-the-art update,” Journal of Hospital Infection 84(1), 5–12 (2013). Crossref
21. W. Xiang, J. Peng, X. Song, A. Xu, D. Zhang, J. Liu, and Z. Bi, “In vivo visualization of honeycomb pattern, cobblestone pattern, ringed pattern, and dermal papillae by confocal laser scanning microscopy,” Skin Res Technol 22(1), 32–39 (2015). Crossref
22. M. E. Darvin, M. C. Meinke, W. Sterry, and J. Lademann, “Optical methods for noninvasive determination of carotenoids in human and animal skin,” Journal of Biomedical Optics 18(6), 061230 (2013). Crossref
23. M. E. Darvin, W. Sterry, J. Lademann, and T. Vergou, “The Role of Carotenoids in Human Skin,” Molecules 16(12), 10491–10506 (2011). Crossref
24. S. F. Haag, B. Taskoparan, M. E. Darvin, N. Groth, J. Lademann, W. Sterry, and M. C. Meinke, “Determination of the antioxidative capacity of the skin in vivo using resonance Raman and electron paramagnetic resonance spectroscopy,” Experimental Dermatology 20(6), 483–487 (2011). Crossref
25. M. C. Meinke, A. Friedrich, K. Tscherch, S. F. Haag, M. E. Darvin, H. Vollert, N. Groth, J. Lademann, and S. Rohn, “Influence of dietary carotenoids on radical scavenging capacity of the skin and skin lipids,” European Journal of Pharmaceutics and Biopharmaceutics 84(2), 365–373 (2013). Crossref
26. I. V. Ermakov, M. R. Ermakova, W. Gellermann, and J. Lademann, “Noninvasive selective detection of lycopene and ?-carotene in human skin using Raman spectroscopy,” Journal of Biomedical Optics 9(2), 332 (2004). Crossref
27. M. E. Darvin, I. Gersonde, H. Albrecht, S. A. Gonchukov, W. Sterry, and J. Lademann, “Determination of beta carotene and lycopene concentrations in human skin using resonance Raman spectroscopy,” Laser Phys 15(2), 295–299 (2005).
28. M. E. Darvin, I. Gersonde, H. Albrecht, M. Meinke, W. Sterry, and J. Lademann, “Non-invasive in vivo detection of the carotenoid antioxidant substance lycopene in the human skin using the resonance Raman spectroscopy,” Laser Physics Letters 3(9), 460–463 (2006). Crossref
29. P. Williamson, “Quantitative estimation of cutaneous bacteria” in Skin Bacteria and their Role in Infection, H. I. Maibach, and G. Hildick-Smith (eds.), McGraw Hill, New York (1965)
30. S. H. Maier, A. Kramer, “Prävention von Surgical Site Infections (SSI),” Zentralbl Chir 139(03), 245-250 (2014). Crossref
31. K. Hesterberg, S. Schanzer, A. Patzelt, W. Sterry, J. W. Fluhr, M. C. Meinke, J. Lademann, and M. E. Darvin, “Raman spectroscopic analysis of the carotenoid concentration in egg yolks depending on the feeding and housing conditions of the laying hens,” Journal of Biophotonics 5(1), 33–39 (2011). Crossref
32. I. Wanke, Y. Skabytska, B. Kraft, A. Peschel, T. Biedermann, and B. Schittek, “Staphylococcus aureus skin colonization is promoted by barrier disruption and leads to local inflammation,” Exp Dermatol 22(2), 153–155 (2013).
33. B. Lange-Asschenfeldt, D. Marenbach, C. Lang, A. Patzelt, M. Ulrich, A. Maltusch, D. Terhorst, E. Stockfleth, W. Sterry, and J. Lademann, “Distribution of Bacteria in the Epidermal Layers and Hair Follicles of the Human Skin,” Skin Pharmacology and Physiology 24(6), 305–311 (2011). Crossref
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