Conclusion There are many risk factors associated with developing an infection after elective shoulder surgery .
The findings of this systematic review are clinical ly relevant as it has been shown that infection after shoulder surgery results in poor patient-reported outcomes and pose a significant financial burden .
Purpose Infection is a concern after all orthopedic procedures , including shoulder surgery .
This systematic review of literature aim ed to determine risk factors for infection as well as the availability and effectiveness of measures utilized to prevent infection after elective shoulder surgery .
The effect of axillary hair on surgical antisepsis around the shoulder.
BACKGROUND Infection after shoulder surgery can have devastating consequences . Recent literature has implicated Propionibacterium acnes as a causative agent for postoperative shoulder infections . Axillary hair removal has been suggested as a method for infection prevention , although data quantifying its effect on the bacterial load around the shoulder are lacking . METHODS We clipped  one r and omly selected axilla in 85 healthy male volunteers with commercially available surgical clippers . Aerobic and anaerobic culture specimens were taken from the clipped and unclipped axillae . Each shoulder was then prepared with 2 % chlorhexidine gluconate and 70 % isopropyl alcohol . Repeated culture specimens were then taken from both axillae . Cultures were held for 14 days and recorded with a semiquantitative system ( 0 - 4 points ) . Results were compared by the Wilcoxon signed rank test . RESULTS There was no difference in the burden of P. acnes between the clipped and unclipped axillae before or after surgical preparation ( P = .109 , P = .344 , respectively ) . There was a significantly greater bacterial burden in the clipped shoulder compared with the unclipped shoulder before preparation ( P < .001 ) but not after preparation ( P = .285 ) . There was a significant reduction in total bacterial load and P. acnes load for both axillae after surgical preparation ( P < .001 for all ) . CONCLUSIONS Removal of axillary hair has no effect on the burden of P. acnes in the axilla . Clipped axillae had a higher total bacterial burden . A 2 % chlorhexidine gluconate surgical preparation is effective at removal of all bacteria and specifically P. acnes from the axilla
Conclusion There are many risk factors associated with developing an infection after elective shoulder surgery .
The findings of this systematic review are clinical ly relevant as it has been shown that infection after shoulder surgery results in poor patient-reported outcomes and pose a significant financial burden .
Purpose Infection is a concern after all orthopedic procedures , including shoulder surgery .
This systematic review of literature aim ed to determine risk factors for infection as well as the availability and effectiveness of measures utilized to prevent infection after elective shoulder surgery .