Influence of doxycycline on wound healing: a systematic review, meta-analysis and GRADE assessment of animal experimental trials

Objective To evaluate the influence of doxycycline on wound healing activity compared to control interventions, such as saline, chitosan, or other pharmacological agents. Materials and methods The following databases Medline (PubMed), Embase, Scopus, and Web of Science were searched for the relevant studies. A total of 94 records were screened after the removal of duplicates and 16 trials were included. Considering the similarity in outcome measures, data was pooled from nine trials using Comprehensive Meta Analysis (CMA) 3.0 software. The level of significance was p<0.05 and the certainty of the evidence was evaluated using GRADE pro GDT. Results A pooled analysis of nine trials assessing the wound healing in percentage (SMD 2.952, 95% CI:[0.597 to 5.307], p<0.014) significantly favoured doxycycline over the control agents. In the SYRCLE tool, four out of nine criteria displayed a low risk of bias in more than 50% of the included studies (more than 8 studies). This, along with low/unclear risk of bias, minimised imprecision and indirectness in the included trials, leading to high certainty of evidence. Conclusion Doxycycline shows notable advantages in wound healing compared to placebos or other agents, but replicability in clinical settings is necessary. Definitive pooled evidence from human trials is crucial to determine its precise clinical implications.