Disposable surgical face masks: a systematic review

Area of Science:

• Surgical Infection Prevention
• Healthcare-Associated Infections
• Microbiology in Surgery

Background:

• Surgical face masks were initially designed to protect patients from healthcare workers' expelled droplets.
• Concerns exist regarding surgical masks potentially contaminating surgical wounds.
• The role of surgical masks in preventing surgical wound infections remains debated.

Purpose of the Study:

• To systematically review randomized controlled trials evaluating disposable surgical face masks.
• To assess the efficacy of surgical masks worn by surgical teams during clean surgery.
• To determine the impact on postoperative surgical wound infection rates.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) and quasi-RCTs.
• Searched Cochrane Wounds Group Specialised Trials Register and contacted manufacturers and professional organizations.
• Included studies comparing disposable surgical masks versus no mask in clean surgery.

Main Results:

• Two RCTs with 1453 patients were included.
• A small trial showed a trend towards fewer infections with masks; a large trial found no difference.
• Neither trial adequately accounted for cluster randomization in their analysis.

Conclusions:

• The evidence regarding the harm or benefit of surgical face masks in clean surgery is limited and inconclusive.
• Further high-quality research is needed to definitively establish the role of surgical masks.
• Current data does not clearly support or refute the routine use of surgical masks for preventing surgical wound infections.