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I just got my preop instructions for a total knee replacement. I was told to shower the night before but not to shave my legs. That seems like contradictory advice. I always shave when I shower. Why do they give out these instructions?

Preop showering is to help prevent infection. Most surgeons, clinics, and hospitals have a detailed regimen to help patients avoid infections. One way to do this is to wash away as many of the bacteria on the skin as possible.

Avoiding local (skin or wound) infections can prevent deeper (joint) infections. Deep infection requires the use of IV antibiotics and can lead to more surgery. The patient could even lose the implant if the infection causes it to loosen up.

Hair removal by shaving can leave tiny nicks in the skin where bacteria can enter. The surgeon does remove the hair from around the surgical site. But they use clippers instead of razors to protect you.

There are many other steps taken by all involved to prevent infection. Hand washing, step-by-step sterile procedures, and the routine use of antibiotics are just a few. Patients can do their part by following a few simple instructions such as you've received.

As Ben Franklin once said, "An ounce of prevention is worth a pound of cure." Hand washing, showering, and careful skin prep are small ounces of infection prevention.

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