title: Superiority of 5% NaHCO3 for preoperative hair removal in patients undergoing coronary artery bypass graft surgery with a limb vein: a randomized controlled trial†.
abstract: OBJECTIVE
  Compared with a dry environment with talcum powder, a wet, alkaline environment with NaHCO3 solution is better for hair removal, as it can soften and expand the hair, decrease the friction and shear forces on the skin, and make hair removal easier and more efficient. The purpose of this study was to compare the effects of a preoperative skin preparation of 5% NaHCO3 with that of talcum powder for softening hair in patients undergoing coronary artery bypass graft (CABG) surgery with the saphenous vein.
  
  
  METHODS
  A prospective randomized, single-blinded, controlled study was established. Between March 2012 and June 2013, 120 patients who met the inclusion and exclusion criteria underwent elective CABG surgery with the saphenous vein in our hospital. The same doctor obtained the saphenous vein of each patient by a uniform method. CABG surgery was performed through an open or endoscopic technique, according to each patient's condition. Patients were divided into two groups of 60 patients each, according to whether the preoperative skin preparation procedure was performed with a 5% solution of NaHCO3 at 45-50°C (experimental group) or with talcum powder (control group). Main outcome measures were the incision inflammation rate, skin preparation time, presence of shaving-induced macroscopic haemorrhagic spots, verbal rating scale (VRS) pain score and satisfaction.
  
  
  RESULTS
  Neither group had any evidence of incision inflammation. The average (mean ± standard deviation) skin preparation time of the experimental group was shorter than that of the control group (5.58 ± 1.52 vs 9.74 ± 1.23 min, P < 0.001). Three patients in the experimental group and 17 in the control group had shaving-induced macroscopic haemorrhagic spots after skin preparation (P = 0.001). The VRS pain scores were different between the two groups (P < 0.001). In the control group, 40% of patients and 37% of nurses were satisfied with the skin preparation procedure, compared with 95 and 90%, respectively, in the experimental group (both P < 0.001).
  
  
  CONCLUSIONS
  Hair softening with a 5% NaHCO3 solution protected the skin integrity, alleviated pain and improved patient satisfaction to a greater extent than talcum powder. Nurses found the 5% NaHCO3 solution to be more convenient and less time-consuming to use.
authors.affiliation: Nursing College of Nantong University, Nantong City, Jiangsu Province, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Ding
authors.affiliation: Nursing Department, Affiliated Hospital of Nantong University, Nantong City, Jiangsu Province, China.
authors.forename: Hong-Lei
authors.initials: HL
authors.lastname: Wu
authors.affiliation: Nursing Department, Affiliated Hospital of Nantong University, Nantong City, Jiangsu Province, China.
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Zhu
authors.affiliation: Nursing Department, Affiliated Hospital of Nantong University, Nantong City, Jiangsu Province, China.
authors.forename: Min
authors.initials: M
authors.lastname: Ding
authors.affiliation: The Second Affiliated Hospital of Nantong University, Nantong City, Jiangsu Province, China.
authors.forename: Yun-Lei
authors.initials: YL
authors.lastname: Wang
authors.affiliation: Nursing Department, Affiliated Hospital of Nantong University, Nantong City, Jiangsu Province, China xxj_1124@126.com.
authors.forename: Xu-Juan
authors.initials: XJ
authors.lastname: Xu
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006204:Hair Removal / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain; D017060:Patient Satisfaction; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D017693:Sodium Bicarbonate / Q000627:therapeutic use*
chemical_list: D017693:Sodium Bicarbonate
keywords: Hair softener; NaHCO3 solution; Skin preparation