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BACKGROUND AND AIM: Face masks are routinely worn by healthcare personnel as an infection prevention measure during surgical procedures in hospitals. Their use is more variable in general practice and emergency clinics. We assessed the scientific evidence underpinning the use of face masks during invasive surgical procedures to prevent postoperative infections.

EVIDENCE BASE: We performed a systematic literature search using predefined criteria in the Medline, Embase and Cochrane Library databases. The intervention was the use or non-use of face masks during invasive surgical procedures. The outcome was clinical infection.

RESULTS

The literature search yielded 675 records and identified eight relevant studies. An additional study was identified from the reference lists. Eight of the nine studies, including the two with the highest methodological quality, found no significant difference in postoperative infection rates according to whether face masks were used or not. In the two studies with the highest quality, the differences between the two groups in terms of the proportion with an infection were 1.2% and 3.5%, respectively. One study found a significantly higher infection rate when face masks were used.

INTERPRETATION: There is insufficient high-quality scientific evidence to support the use of face masks during invasive surgical procedures to reduce the incidence of postoperative infections.