I am writing this as a wet shaver and a general surgeon with an interest in history. Surgeons split off from barbers, the original shavers, to follow armies at war, thus learning the management of wounds.
As late as the Renaissance, surgeons were referred to as Mister, while the “ doctors” ministered as priests, never touching blood. It was only the drainage of an abscess by a French surgeon on a Royal’s Buttock, that elevated European surgeons to the title of Doctor. To this day, as a rejection of all things French, British surgeons are still referred to as Mister!
The very aspects of hair, that make it great material for shaving brushes (air space) is what makes hair a risk for a surgical patient. That water and heat retention occur means there are many small spaces for bacteria to hide in hair, so it’s got to go, (except in special cases). Bacteria counts correlate well to wound infection rates.
This means that shaving is healthful and prevents disease/complications.
In the mid 20th century double-edged blades, and cream from a small aerosol can were still used in preparation for surgery. Those razors loaded with med tech blades soon morphed into plastic replicas of double-edged razors with a single edge blade inserted in the plastic at each edge. Sometimes the shaves were field style or dry. Then plastic cheap razors infiltrated the hospitals from the emergency rooms up. Now a safety razor cannot be found in an American hospital.
In the late 1980’s a single journal article, poorly crafted, swung the tide toward electric razors. The research stated that a sharp edged shave the night before surgery caused more infections than an electric clipper at the time of surgery Sadly, they never compared the electric clipper to a shave at the time of surgery!
Since that time, hair removal in the operating room is by electric clipper, and, by the way wound infection rates have risen. Any wet shaver can explain it. The electric razor leaves stubble, which is residual hair, and hair contains hidden bacteria!
Face shaving for cosmesis (DFS/BBS), meant many people knew how to shave, so pre operative shaves were performed by skilled shavers. The proliferation of disposable and electric razors in the general population means fewer of the operating room staff today, knows how to wet-shave and that promotes continued use of the electric with increasing wound infection rates over the past 20 years.
Generally a small area of skin is shaved in the region of a planned incision. Since a man’s beard is far hairier than most body parts in most people, there is not much skill needed to perform a pre-operative shave. The need to do it properly however is reuniting barbers and surgeons after a centuries long estrangement!
Larry Isaacs, MD