ArticlePloS one2025
Risk factors for delayed wound healing after anal fistula surgery: Protocol of a meta-analytic study.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed.
- Article
- Pathophysiological mechanisms and clinical management of type 2 diabetes mellitus complicated with anal fistula.Frontiers in surgery · 2026Review
- Risk factors for fecal incontinence after surgery for cryptoglandular anal fistula: Protocol of a meta-analytic study.PloS one · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDelayed wound healing (DWH) following anal fistula surgery is a common complication that prolongs recovery, increases patient morbidity, and imposes significant healthcare costs. Potential risk factors such as diabetes, smoking, fistula complexity, and surgical techniques have been suggested in individual studies, yet no comprehensive synthesis exists to guide clinical practice. This study aims to identify and evaluate risk factors associated with DWH after anal fistula surgery by combining existing evidence and grading the evidence. METHODS AND ANALYSIS: This study will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. We will search PubMed, Embase, Cochrane Library, Web of Science, and grey literature databases from inception to March 2025, with no language restrictions. Observational studies (cohort and case-control) reporting risk factors for DWH, defined as incomplete healing beyond 6-12 weeks post-surgery, will be included. Two independent reviewers will screen titles/abstracts, perform full-text reviews, extract data regarding study design, sample size, risk factors and outcomes, and assess risk of bias using the Newcastle-Ottawa Scale (NOS). Primary outcomes will include odds ratios (OR) or relative risks (RR) for factors such as comorbidities, lifestyle factors, and operative approaches. A random-effects meta-analysis will pool effect estimates if heterogeneity (I² < 50%) permits; otherwise, a narrative synthesis will be conducted. Subgroup analyses will explore differences by study design and patient characteristics, with publication bias assessed using funnel plots and Egger's test. The certainty of evidence will be evaluated with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. DISCUSSION: This study's strengths include its comprehensive search strategy and rigorous methodology, providing a robust synthesis of risk factors. Clinically, identifying modifiable risk factors could enhance preoperative optimization and postoperative care, reducing delayed healing rates. Future studies should standardize definitions of delayed healing and explore under-investigated factors like wound care techniques or microbiome influences to refine risk prediction models. REGISTRATION: PROSPERO CRD420251013602.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.