Incidence of Surgical-Site Infections Following Oral and Maxillofacial Surgery: A Systematic Review and Meta-Analysis

Surgical-site infections (SSIs) following oral and maxillofacial surgery (OMFS) represent a significant healthcare concern due to the unique anatomical and microbiological challenges of the surgical field. The oral cavity harbors a dense and diverse microbiota, and OMFS procedures frequently involve mucosal breaches, increasing susceptibility to infection. This systematic review and meta-analysis aimed to estimate the global incidence of post-OMFS SSIs and identify associated risk factors and causative pathogens.

We searched international databases and studies reporting post-OMFS incidence were included, adhering to predefined criteria. Data extraction and quality assessment were performed using standardized tools. We used random-effects meta-analysis to estimate the global and regional post-OMFS incidence. Heterogeneity was assessed using I ², and further analyses, including subgroup and meta-regression analyses, were conducted to identify its sources.

A total of 50 studies comprising 57,159 patients, published between 1980 and 2023, across 22 countries were included. The global pooled incidence of post-OMFS SSIs was estimated at 6.03% (5.33-6.73%), with the highest and lowest rates observed in South Asia (15.07%, 3.63-26.5%) and North America (4.02%, 1.66-6.37%), respectively. Incidence rate was higher in countries with lower levels of income and human development index. Risk factors identified included gender, smoking, higher body mass index, diabetes, antibiotic practices, and specific surgical variables. The primary causative pathogens were Streptococcus spp., Pseudomonas spp., Bacteroides spp., Escherichia coli, and Klebsiella spp.

This study provides a comprehensive understanding of post-OMFS SSIs globally, emphasizing the importance of tailored preventive measures. The scarcity of data for various regions warrants increased attention. Healthcare providers should be vigilant regarding identified risk factors and causative pathogens, implementing targeted strategies to mitigate SSIs in OMFS.

The online version contains supplementary material available at 10.1007/s12663-025-02682-2.