An Innovative Technology with Vacuum Support in Providing Safe Epilation Before Surgical Cutting

Surgical intervention continues to be the first choice in many cases, either mandatory or optional, with curative, palliative and prophylactic purposes such as diagnostic, explorative, ablative, reconstructive, constructive. Surgical field infections are the most common healthcare-related infections. Therefore, the importance of innovative approaches to prevent surgical site infections is increasing day by day. In this review, “a vacuum assisted surgical hair clipper” is proposed as an innovative technology to provide safe epilation to prevent health care-related infections.

published in 2009 found that there was no statistically significant difference in SSI rates between shaving and not shaving the surgery area before surgery [7].
However, the epilation of the surgical field in clinics is frequently preferred in orthopedics, lower and upper extremity surgery, cardiovascular surgery, surgery involving the gastroitestinal system and neurosurgery concerning the scalp, the reason of this the hair is a source for the bacteria, the surgical intervention is difficult and the hair removal provides ease of dressing and suturing [7]. For this reason, epilation of the incision area in the preoperative period is an important step in skin preparation, which is a part of the strategy of preventing SSI. It is known that the risk of SSI increases in patients who do not use the right techniques and methods in epilation.
In the literature, while electric devices and hair removal creams, which are defined as clippers for hair removal, are recommended, it is emphasized that the razor is an application that should definitely be avoided [3,4]. The razor is not strongly recommended because it causes small cuts in the patient's skin and damages the hair follicles and increases the risk of SSI by providing a good environment for the growth of microorganisms [1]. Although depilatory creams are the least destructive / irritating method, sensitivity test should be performed before use, since some people may cause serious skin reactions. The potential for allergic reactions and the need to wait 15-20 minutes for hair loss reduces clinical use of hair removal [8].
Clipping scissors have proven to be superior to other methods in terms of maintaining skin integrity. Centers for Disease Control and Prevention (CDC) and The Association of Peri Operative Registered Nurses (AORN) recommend that it be performed in a room outside the operating room in the form of clipping with electric scissors just before the surgery if the hair needs to be removed [9]. Lefebvre et al. [10] found in meta-analysis that shaving for epilation increases the risk of infection and that chemical depilation and trimming are similar in terms of infection. However, Shi et al. [11] found that there was no difference between shaving, clipping and chemical depilation. Electric clippers are safely recommended in almost every guide, due to less irritation [3,4,8]. However, the dispersion (scattering) that occurs during clipping spreads to the objects around the patient, to the floor, to a larger area of the skin and to the air, and the hair and skin particles contaminate the surgical environment. Because these particles contain the same pathogenic bacteria as the skin. Noguchi [12] states that surgical site infections due to intraoperative contamination can be attributed mainly to airborne particles carrying microorganisms. In a limited number of studies, it is reported that vacuum-supported trimming scissors collect more hair, shorten the processing time, reduce the number of particles and microbial load in the environment and skin area, and minimize skin irritation [13]. Thanks to the vacuum assisted shaver, after the hairs are cut, the hair will be filled in the receptacle of vacumm without falling into the surgical area and the sterility of the operating room will be preserved.

Conclusion
Vacuum-assisted clipper may be recommended instead of standard clippers to prevent the dispersion of the hair and skin particles into the environment to provide safe epilation before surgery.