Systematic mapping review of interventions to prevent blood loss, infection and relapse in orthognathic surgery

Background: This systematic mapping review aims to identify, describe, and organize the currently available evi-dence in systematic reviews (SR) and primary studies regarding orthognathic surgery (OS) co-interventions and surgical modalities, focusing on the outcomes blood loss, infection and relapse. Material and Methods: A comprehensive search strategy was performed to identify all SRs, randomized con-trolled trials and observational studies that evaluate surgical modalities and perioperative co-interventions in OS that evaluate the outcomes blood loss, infection and relapse, regardless of language or publication date. Searches were conducted in MEDLINE, EMBASE, Epistemonikos, Lilacs, Web of Science, and CENTRAL. In addition, grey literature was screened. Results: 27 SRs and 150 primary studies fulfilled the inclusion criteria, 91 from SRs, and 59 from our search strat-egy. Overall, the quality of the SRs was graded as Critically low, and only two SRs were rated as High qual-ity. 11 PICO questions were extracted from SRs and 31 from primary studies, which focused on osteosynthesis methods, surgical cutting devices, use of antibiotics, and induced hypotension. In addition, evidence bubble maps for each outcome were created to analyze in a visual manner the existing evidence. Conclusions: Future primary and secondary high-quality research should be addressed focused on the eight knowledge gaps identified in this mapping review. We concluded that the evidence mapping approach is a practi-cal methodology for organizing the current evidence and identifying knowledge gaps in OS, helping to reduce research waste and canalize future efforts in developing studies for unsolved questions.

Automated summary

This systematic mapping review aims to identify, describe, and organize the currently available evidence regarding orthognathic surgery co-interventions and surgical modalities. The quality of the included systematic reviews was generally low, and the study identified several knowledge gaps that need to be addressed in future high-quality research.