Evidence Hub

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

BMC Infectious Diseases, 2025

1 citation

Abstract

OBJECTIVE: To evaluate the clinical efficacy of metronidazole topical solution in preventing surgical site infections and promoting wound healing. METHODS: A 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. RESULTS: Eight 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. CONCLUSION: Metronidazole topical rinse may be more effective…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

Read the paper

Related studies

Go deeper in Evidence Hub

Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.

Open this study Sign up free