Shaving of the scalp may increase the rate of infection in CSF shunt surgery.

Hydrocephalic patients undergo repetitive surgical procedures, most of which involve the scalp. 141 shaveless operations involving scalp incisions for cerebrospinal fluid (CSF) shunts as well as 218 historical controls were reviewed after the senior author ceased shaving the scalp. The study population has been followed for a mean of 13.4 months and the control population for a mean of 38.6 months. The actuarial rate of infection at 1 year was 3.3% in the study population and 6.9% in the control population. Anesthesia times were not significantly different. Shaving of the scalp is not a critical step in the prevention of CSF shunt infection.