Antibiotic-containing ointments, such as polymyxin B-bacitracin ointment, mupirocin ointment and bacitracin ointment, are commonly used for postoperative wound care. The ointment base in each case is mainly white petrolatum. Smack and colleagues conducted a randomized controlled trial to compare the incidence of infection and allergic reaction, as well as healing characteristics, after using white petrolatum versus bacitracin ointment on "clean" postprocedure sites.
A total of 1,207 wounds in 884 healthy, nonpregnant adults were evaluated in the study. The wounds were the result of a variety of procedures' including punch biopsy, dermabrasion, Mohs microsurgery and excision. After each procedure, the area was cleaned with water and hydrogen peroxide, and patients were randomized to receive an application of either white petrolatum or bacitracin. Patients cleaned and dressed the wound for seven to 10 days. Wounds were checked for signs of healing or infection for four weeks after the procedure, and patient compliance was assessed by determining the amount of ointment used during this period. At each follow-up visit, the wound sites were assessed for signs of infection, allergic contact dermatitis and healing characteristics.
Infection developed in nine (2 percent) of the wounds in patients treated with white petrolatum, compared with four (0.9 percent) of the wounds in patients treated with bacitracin. Allergic contact dermatitis was observed in four (0.9 percent) of the patients in the bacitracin group, but in none of the patients in the white petrolatum group. No significant differences in healing characteristics were observed between the petrolatum and bacitracin groups. Analysis of possible risk factors for infection did not reveal an association between infection and the amount of ointment used.
The authors cite white petrolatum's lower cost ($0.74 per 15 g versus $2.18 per 15 g for bacitracin), similar incidence of infection and degree of healing, and lower incidence of allergic reactions as reasons for advocating use of white petrolatum for wound care after ambulatory surgery.
Smack DP, et al. Infection and allergy incidence in ambulatory surgery patients using white petrolatum vs. bacitracin ointment: a randomized controlled trial. JAMA 1996;276:972-7.
COPYRIGHT 1996 American Academy of Family Physicians
COPYRIGHT 2004 Gale Group
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