Preventing Surgical Site Infections in Oral and Maxillofacial Surgery: Current Challenges and Emerging Solutions

Abstract

Surgical site infections (SSIs) in oral and maxillofacial (O&M) surgery are significant healthcare-associated complications that increase morbidity, healthcare costs, and antibiotic resistance. This review provides a comprehensive overview of SSI preventive measures in O&M surgeries, classified into pre-, intra-, post-, and preoperative stages. Key strategies include antiseptic applications (e.g. chlorhexidine gluconate and povidone-iodine), optimised hand and wound hygiene, hair removal, and maintaining key patient vitals. The review explores the roles of additional measures, such as antimicrobial sutures, Negative Pressure Wound Therapy (NPWT), and nutritional optimisation. Although certain measures—such as antibiotic prophylaxis for clean surgeries and preoperative bathing—remain controversial, antiseptic dressings, laminar airflow, incisional wound irrigation, hand preparation, wound guards, gowns, drapes, and gloves, antibiotic sutures, increasing nutritional intake, maintaining normal body temperature, oxygen supplementation, blood glucose control, postoperative NPWT, chlorhexidine and PVD-I as skin preparation, and fluid therapy have shown promise in reducing SSI risk. The review also highlighted the inadequate hand hygiene among dental practitioners raising concerns about the risk of SSIs. In conclusion, this review highlights the need for tailored, evidence-based protocols, adherence to care bundles, and ongoing evaluation of new research to improve patient outcomes and enhance healthcare efficiency in O&M surgery.