Pre-operative preparation for knee surgery involves many rules and instructions. While general guidelines exist, it is important to confirm every specific instruction with the treating surgeon or hospital staff, as protocols can vary slightly between institutions. Understanding the rationale behind these rules, especially concerning personal grooming, helps ensure the safest outcome.
Facial Shaving: The Direct Answer
For knee surgery, shaving the face or other body areas far removed from the surgical site is generally acceptable. Standard hygiene practices are encouraged before hospital admission. Facial hair is physically separate from the sterile field created for the knee procedure, so the risk of introducing bacteria near the incision is minimal. If you maintain a regular shaving routine, continuing to shave your face with a standard razor is permitted, provided you do not nick or cut your skin. Some facilities recommend using an electric shaver or trimmer for pre-operative hair removal to minimize the chance of creating small skin breaks.
Surgical Site Hair Removal: Understanding Infection Risk
While shaving the face is permissible, rules regarding hair removal around the surgical site—your knee and leg—are much stricter due to infection risk. Patients should never shave the area where the incision will be made in the days leading up to the procedure. Shaving with a razor blade creates microscopic abrasions and cuts on the skin’s surface, which act as entry points for bacteria. These small wounds allow bacteria that live on the skin to enter, multiply, and significantly increase the risk of a Surgical Site Infection (SSI). Medical guidelines strongly advise against using razors near the operative site, as studies show shaving is associated with a higher incidence of SSI. If hair removal is necessary because the hair is thick enough to interfere with the surgical procedure, the hospital staff will perform it. This is done using electric clippers with a single-use head, not a razor, immediately before the operation. Clipping minimizes skin trauma and bacterial colonization. If you have concerns about hair on your leg near the knee, leave it untouched and allow the surgical team to handle it according to their sterile protocols.
Beyond Shaving: Essential Pre-Operative Protocols
Adherence to specific pre-operative instructions that go beyond grooming is important for patient safety and surgical success.
Fasting (NPO Protocol)
One critical rule concerns fasting, known as the “nil per os” (NPO) protocol, which means “nothing by mouth.” Fasting typically requires patients to stop eating solid food and milk products six to eight hours before the surgery time, often after midnight. This rule prevents pulmonary aspiration, a dangerous event where stomach contents are inhaled into the lungs while under general anesthesia. Clear liquids, such as water or black coffee, may be permitted up to two hours before the procedure, but you must follow the specific timing given by the anesthesiologist. Failure to follow NPO instructions can lead to the postponement or cancellation of the surgery.
Medication Management
Medication management requires strict attention, especially for patients taking daily pills or supplements. The surgical team will provide a list of medications to stop taking, such as blood thinners, which can cause excessive bleeding during surgery. Certain herbal supplements and high-dose vitamins may also need to be discontinued beforehand. Conversely, some medications, like those for heart conditions or blood pressure, are often continued and should be taken with a small sip of water on the morning of surgery.
Antiseptic Bathing
Many facilities require pre-operative bathing with an antiseptic cleanser, often containing Chlorhexidine Gluconate (CHG). This special soap, used the night before and the morning of surgery, is designed to reduce the total bacterial load on the skin’s surface. Using CHG from the neck down helps significantly lower the risk of SSIs. Following these specific protocols is the most effective way to prepare for a successful and safe knee surgery.