First the answer: not necessarily! The skin preparation thing, compared with open surgery, seems to be an insignificant “trivial”, but whose hair who cares, especially many of our beautiful long-haired princesses, they than open surgery, but more concerned about their hair, regardless of the answer: not necessarily! Skin preparation, and craniotomy, seems to be an insignificant “small thing”, but whose hair who cares, especially many of our beautiful long-haired princesses, they are more concerned about their hair than craniotomy, no matter how unwilling to turn from a small princess into a small monk. However, when parents are concerned about their children’s hair, they must be more worried about whether not shaving their heads will cause infection. So, will not shave your head or not increase the rate of infection? The answer will certainly surprise you, there is a special study comparing between preoperative shaving and not shaving and wound infection, the conclusion is that not only does not shaving increase the infection rate, but also lower than the infection rate of shaved head. Let’s take a look at what’s involved in this “inconspicuous” little thing called preoperative skin preparation. Skin preparation, also known as “skin preparation”, refers to the cleaning and exposure of the corresponding scalp incision site during surgery, and is a very important part of the preoperative preparation for neurosurgery. Skin preparation includes not only shaving, but also cleaning of the scalp and hair (which is different from surgical sterilization). There are a huge number of bacteria, fungi and other microorganisms hidden on the surface of the scalp and inside the hair, and if these microorganisms are not well controlled, it will directly affect the incidence of postoperative infection. Therefore, the traditional view is that removing all the hair is a safer and cleaner practice, which also facilitates the accurate positioning of the incision and intraoperative operation. But why is the infection rate increased by shaving the hair instead? The main reason is that shaving is basically done the day before the procedure, mostly by pushing the hair off with a pusher and then shaving the stubble with a razor to smooth it out. However, in the process of shaving hair on the scalp, it is difficult to avoid the appearance of small scalp breakage, there is a little bleeding since there must be a breakage, even in the naked eye does not look obvious bleeding, with a microscope carefully observed, there will almost always be some fine scalp surface breakage, these small breakage is left to the surface of the scalp pathogens into the scalp opportunity. Moreover, the time of skin preparation is often the day before the surgery, and after these bacteria enter the scalp, they will have sufficient time to multiply in the blood supply of the scalp, tissues and blood, thus increasing the chances of surgical infection. Thus, unnecessary “shaving” does not provide additional benefits, but may lead to higher infection rates. For children who must have their heads shaved, such as those at high risk of acute obstructive hydrocephalus, or those who require intraoperative stereotactic navigation for puncture positioning or bilateral surgery, it is still necessary to shave the entire head for safety and surgical reasons, but not with a skin preparation knife, and preferably on the day of surgery, as close to the time of surgery as possible, to reduce the time for bacteria to enter the scalp and multiply. The best time to do this is close to the day of the surgery to reduce the time for bacteria to enter the scalp. Of course, if the head is not shaved at all, it does increase some difficulties during the operation, including the difficulty of positioning the scalp incision design when covered with full hair, the need for a more rigorous disinfection process, the hair will inevitably remain inside the operative field, and it is difficult to fix the gauze covering the wound after the operation. Therefore, local preparation of the skin in the incision area is more widely used nowadays. The day before the surgery, the surgeon needs to design the incision accurately by the lesion area, and use a non-invasive electric razor that will not hurt the scalp to shave an area about 3-5 cm wide along the incision. This ensures localized skin cleanliness and reduces the impact on the child’s appearance and psychological well-being. Studies have found that this small strip of localized scalp preparation does not increase the rate of post-operative infection, indicating that this practice is very safe. On the day of surgery, the surgeon will “wash” the child’s hair again in the operating room using hand brushing solution and iodophor, and then strictly cover the hair with a transparent film, and the surgical towel will be placed strictly along the incision, using an adhesive disposable surgical towel to separate the hair from the incision and avoid entering the surgical field. At the Children’s Neurosurgery Center at Xuanwu Hospital, most children are treated with localized skin preparation around the incision, and there has not been a single case of infection caused by preserved hair. For children who are beginning to develop a sense of self, especially little girls who love beauty, “shaving the head” may cause more or less psychological harm to them. From a psychological and aesthetic point of view, hair preservation is also of great importance for the youngest children.