What do systematic reviews say?

Surgical vs radiological treatment

Surgical treatment showed no clear difference in varicocele recurrence compared with radiological treatment (low certainty).

• Surgical or radiological treatment for varicoceles in subfertile men 2021 · Cochrane Headline outcomes only
  RR 1.31 [0.82, 2.8]
  3 studies · 380 participants
  Low

Surgical interventions (exploration and decompression / external neurolysis, internal neurolysis, neurorrhaphy / direct repair, neuroma excision, anastomosis, autologous or allograft nerve grafting or tubulization) vs conservative interventions

• Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults 2019 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 112 participants
  Low

Surgical interventions (exploration and decompression / external neurolysis, internal neurolysis, neurorrhaphy / direct repair, neuroma excision, anastomosis, autologous or allograft nerve grafting or tubulization) vs conservative interventions

It is very uncertain whether surgical intervention changes pain: presence of pain (slight or moderate) at 1 year compared with conservative intervention (very low certainty).

• Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults 2019 · Cochrane Headline outcomes only
  RR 1.32 [0.54, 3.19]
  1 study · 79 participants
  Very low

Surgical interventions (exploration and decompression / external neurolysis, internal neurolysis, neurorrhaphy / direct repair, neuroma excision, anastomosis, autologous or allograft nerve grafting or tubulization) vs conservative interventions

It is very uncertain whether surgical intervention changes treatment failure (usually requiring a subsequent operation) at 1 year compared with conservative intervention (very low certainty).

• Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults 2019 · Cochrane Headline outcomes only
  RR 0.99 [0.51, 1.94]
  6 studies · 342 participants
  Very low

Surgical interventions (exploration and decompression / external neurolysis, internal neurolysis, neurorrhaphy / direct repair, neuroma excision, anastomosis, autologous or allograft nerve grafting or tubulization) vs conservative interventions

Surgical intervention showed no clear difference in number of participants to return to work/sport ‐ at 1 year compared with conservative intervention (low certainty).

• Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults 2019 · Cochrane Headline outcomes only
  RR 0.96 [0.85, 1.1]
  2 studies · 137 participants
  Low

Surgical interventions (exploration and decompression / external neurolysis, internal neurolysis, neurorrhaphy / direct repair, neuroma excision, anastomosis, autologous or allograft nerve grafting or tubulization) vs conservative interventions

• Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults 2019 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 122 participants
  Low

Surgical interventions (exploration and decompression / external neurolysis, internal neurolysis, neurorrhaphy / direct repair, neuroma excision, anastomosis, autologous or allograft nerve grafting or tubulization) vs conservative interventions

It is very uncertain whether surgical intervention changes participants with adverse events at 1 year compared with conservative intervention (very low certainty).

• Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults 2019 · Cochrane Headline outcomes only
  RR 2.82 [1.65, 4.82]
  6 studies · 342 participants
  Very low

Surgical interventions (exploration and decompression / external neurolysis, internal neurolysis, neurorrhaphy / direct repair, neuroma excision, anastomosis, autologous or allograft nerve grafting or tubulization) vs conservative interventions

It is very uncertain whether surgical intervention changes patient dissatisfaction with the cosmetic result at 1 yearh compared with conservative intervention (very low certainty).

• Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults 2019 · Cochrane Headline outcomes only
  RR 0.34 [0.07, 1.62]
  1 study · 70 participants
  Very low

Negative pressure wound therapy vs standard dressing

Negative pressure wound therapy probably leads to lower surgical site infection (proportion of participants in each group… compared with standard dressing (moderate certainty).

• Negative pressure wound therapy for surgical wounds healing by primary closure 2022 · Cochrane Headline outcomes only
  RR 0.73 [0.63, 0.85]
  44 studies · 11403 participants
  Moderate

Extended vs short duration antibiotics

It is very uncertain whether extended changes surgical site infections: liver transplant recipients Time frame: 30… compared with short duration antibiotics (very low certainty).

• Perioperative antibiotics for preventing post‐surgical site infections in solid organ transplant recipients 2020 · Cochrane Headline outcomes only
  RR 1.31 [0.61, 2.81]
  1 study · 97 participants
  Very low

Extended vs short duration antibiotics

It is very uncertain whether extended changes surgical site infections* (all) Time frame: 30 days compared with short duration antibiotics (very low certainty).

• Perioperative antibiotics for preventing post‐surgical site infections in solid organ transplant recipients 2020 · Cochrane Headline outcomes only
  RR 1.19 [0.58, 2.48]
  2 studies · 302 participants
  Very low

Extended vs short duration antibiotics

It is very uncertain whether extended changes surgical site infections: kidney transplant recipients Time frame:… compared with short duration antibiotics (very low certainty).

• Perioperative antibiotics for preventing post‐surgical site infections in solid organ transplant recipients 2020 · Cochrane Headline outcomes only
  RR 0.5 [0.05, 5.48]
  1 study · 205 participants
  Very low

Azathioprine or 6‐mercaptopurine vs 5‐aminosalicylic acid (5‐ASA) (mesalazine)

It is very uncertain whether azathioprine or 6‐mercaptopurine changes surgical relapse compared with 5‐aminosalicylic acid (very low certainty).

• Azathioprine and 6‐mercaptopurine for maintenance of surgically‐induced remission in Crohn's disease 2019 · Cochrane Headline outcomes only
  RR 0.81 [0.5, 1.29]
  1 study · 142 participants
  Very low

Azathioprine or 6‐mercaptopurine vs anti TNF‐ɑ

The review found no eligible studies for this question.

• Azathioprine and 6‐mercaptopurine for maintenance of surgically‐induced remission in Crohn's disease 2019 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Azathioprine or 6‐mercaptopurine vs placebo

The review found no eligible studies for this question.

• Azathioprine and 6‐mercaptopurine for maintenance of surgically‐induced remission in Crohn's disease 2019 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Topical antibiotics vs no topical antibiotic.

Topical antibiotics probably leads to lower surgical site infection compared with no topical antibiotic. (moderate certainty).

• Topical antibiotics for preventing surgical site infection in wounds healing by primary intention 2016 · Cochrane Headline outcomes only
  RR 0.61 [0.42, 0.87]
  7 studies · 5427 participants
  Moderate

Topical antibiotics vs antiseptic agent

Topical antibiotics probably leads to lower surgical site infection compared with antiseptic (moderate certainty).

• Topical antibiotics for preventing surgical site infection in wounds healing by primary intention 2016 · Cochrane Headline outcomes only
  RR 0.49 [0.3, 0.8]
  4 studies · 1299 participants
  Moderate

Preoperative showering with chlorhexidine 4% vs placebo

Preoperative showering with chlorhexidine 4% showed no clear difference in surgical site infection compared with placebo (high certainty).

• Preoperative bathing or showering with skin antiseptics to prevent surgical site infection 2015 · Cochrane Headline outcomes only
  RR 0.91 [0.8, 1.04]
  4 studies · 7791 participants
  High

4% chlorhexidine gluconate (CHG) vs soap

It is very uncertain whether chlorhexidine 4% changes surgical site infection compared with bar soap (very low certainty).

• Preoperative bathing or showering with skin antiseptics to prevent surgical site infection 2015 · Cochrane Headline outcomes only
  RR 1.02 [0.57, 1.84]
  3 studies · 1443 participants
  Very low

Chlorhexadine 4% vs no WASH intervention

It is very uncertain whether chlorhexadine 4% changes surgical site infection compared with no wash (very low certainty).

• Preoperative bathing or showering with skin antiseptics to prevent surgical site infection 2015 · Cochrane Headline outcomes only
  RR 0.82 [0.26, 2.62]
  3 studies · 1142 participants
  Very low