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

• Josefina Bendersky ^[4] ; Macarena Uribe ^[1] ; Maximiliano Bravo ^[5] ; Juan Pablo Vargas ^[2] ; Julio Villanueva ^[1] ; Gerard Urrutia ^[3] ; Xavier Bonfill ^[3]
  1. [1] Universidad de Chile

     Universidad de Chile

     Santiago, Chile

     
  2. [2] Pontificia Universidad Católica de Chile

     Pontificia Universidad Católica de Chile

     Santiago, Chile

     
  3. [3] Universitat Autònoma de Barcelona

     Universitat Autònoma de Barcelona

     Barcelona, España

     
  4. [4] Iberoamerican Cochrane Center, Institut d'Recerca-Servei d'Epidemiologia Clínica i Salut Pública, Barcelona, Spain; Universitat autónoma de Barcelona, Campus de la UAB, Barcelona, Spain; Department of Oral and Maxillofacial Surgery and Cochrane Associated Center at Faculty of Dentistry, University of Chile, Santiago, Chile
  5. [5] Oral and Maxillofacial Surgery Program, Universidad de los Andes, Santiago, Chile

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• Localización: Medicina oral, patología oral y cirugía bucal. Ed. inglesa, ISSN-e 1698-6946, Vol. 28, Nº. 2, 2023
• Idioma: inglés
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• Resumen

  • This systematic mapping review aims to identify, describe, and organize the currently available evidence 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.

    A comprehensive search strategy was performed to identify all SRs, randomized controlled 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.

    27 SRs and 150 primary studies fulfilled the inclusion criteria, 91 from SRs, and 59 from our search strategy. Overall, the quality of the SRs was graded as “Critically low,” and only two SRs were rated as “High” quality. 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.

    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 practical 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.