Evidence map›Paper›PMID 41225369›Full record

SynthesisBMC infectious diseases2025

The efficacy of metronidazole rinses in reducing surgical site infections and improving wound healing in patients with purulent appendicitis: a systematic review and meta-analysis.

Ping Han, Sheng Cao

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Ping HanDepartment of Pharmacy, Wuhan Hankou Hospital, No.7, Erqi Side Road, Jiangan District, Wuhan, 430010, China.
Sheng CaoDepartment of Pharmacy, Wuhan Hankou Hospital, No.7, Erqi Side Road, Jiangan District, Wuhan, 430010, China. cslw2024@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the clinical efficacy of metronidazole topical solution in preventing surgical site infections and promoting wound healing.

methodsA comprehensive literature review was conducted using PubMed, EMBASE, Cochrane Database, and China National Knowledge Base to evaluate the impact of metronidazole topical (MS) and physiological saline rinses (SS) on infection rates and wound healing in patients with septic appendicitis after treatment. Review Manager 5.0 was utilized to evaluate the outcomes of the selected studies. The impact of the selected articles was assessed through Forest plot analysis, sensitivity analysis, and bias analysis conducted on the gathered data.

resultsEight studies met the inclusion criteria. The results showed a significantly lower surgical site infection rate in the metronidazole (MS) group compared to the saline (SS) group (RR = 0.28, 100% CI [0.15, 0.51], P = 0.05, I ²= 59%). However, no significant difference was observed in grade I healing rates between the two groups (RR = 1.02, 100% CI [0.91, 1.15], P = 0.41, I ² = 0%). Similarly, there was a significant difference in grade II healing rates ((RR = 0.7, 100% CI [0.32, 1.55], P = 0.30, I² =5%). A significant heterogeneity was observed in grade III healing rates (RR = 0.56, 100% CI [0.17, 1.89], P = 0.21, I² =36%). Sensitivity analysis and funnel plots showed that the study was credible with limited publication bias.

conclusionMetronidazole topical rinse may be more effective and safer than saline rinse in treating purulent appendicitis. Local application of metronidazole to purulent appendicitis incisions is a promising approach. LIMITATIONS: The review was not registered prospectively and some included studies had moderate bias. FUTURE DIRECTIONS: Larger multicenter trials are needed to validate the efficacy of metronidazole irrigation across diverse patient populations.

Indexed as

Anti-Infective AgentsAppendicitisMetronidazoleSurgical Wound InfectionWound HealingAdministration, TopicalHumansTreatment OutcomeAnti-Infective AgentsMetronidazoleLocal irrigationMeta-analysisMetronidazoleSeptic appendicitis disease

Identifiers

PMID41225369
PMCPMC12613349

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Registered trials

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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.