ArticleClinics and practice2022
Increased Risk of Bleeding with Topical Metronidazole in a Postoperative Wound after Anal Fistula and Hemorrhoid Surgery: A Propensity Score-Matched Case-Control Study.
Article in Clinics and practice, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.
- Efficacy of metronidazole in reducing pain after hemorrhoidectomy: a meta-analysis of randomized controlled trials.BMC surgery · 2025Pooled it
- Effect of Neibu Huangqi Youhua formula on postoperative wound healing, inflammatory factors and pain mediators of anal fistula.Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan · 2025Trial
- Article
- Analysis of risk factors and intervention measures for postoperative bleeding in patients with diabetes after proctologic surgery based on a logistic regression model.Frontiers in medicine · 2025Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTopical metronidazole (TM) is commonly used in many infective conditions and postoperative wounds including after anorectal surgery. TM was prescribed in patients operated for benign anorectal conditions (anal fistula and hemorrhoids) to hasten wound healing. After the initiation of this protocol, the incidence of postoperative wound bleeding seemed to increase. There are no data in the literature suggesting that topical metronidazole increases the risk of bleeding.
objectiveAnalysis of the association of TM with an increased risk of bleeding in postoperative anorectal wounds.
designThis was an observational and a retrospective study. Propensity score matching was performed.
settingThis study was conducted at a specialized center for anorectal disorders in postoperative patients suffering from anal fistula and hemorrhoids. MATERIALS: The incidence of postoperative bleeding in the patients in whom TM was used (study group) was retrospectively compared with the patients operated one year before this period in whom TM was not used (control group). SAMPLE SIZE: There were 35 patients in the study group and 181 patients in the control group.
main outcome measuresThe incidence of bleeding and the number of bleeding episodes were evaluated.
resultsThe incidence of bleeding was significantly higher in the study group as compared to the control group (8/35 (22.8%) vs. 8/181 (4.4%), respectively,
conclusionsThe study highlighted that application of topical metronidazole in postoperative anorectal wounds increased the risk of bleeding. Most of the bleeding episodes were controlled with conservative measures but they caused considerable patient anxiety and apprehension.
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