A comparison of postprocedural wound care treatments: Do antibiotic-based ointments improve outcomes?

• Published in: Journal of the American Academy of Dermatology 2011-03, Vol.64 (3), p.S23-S29
• Main Authors: Draelos, Zoe D., MD, FAAD, Rizer, Ronald L., PhD, Trookman, Nathan S., MD, FAAD
• Format: Article
• Language: English
• Subjects: Aquaphor; Bacitracin - therapeutic use; bacitracin zinc; Dermatitis, Allergic Contact - etiology; dermatologic procedures; Dermatology; Double-Blind Method; Drug Resistance, Microbial; Humans; Keratosis, Seborrheic - surgery; Ointments - therapeutic use; Petrolatum - therapeutic use; Polymyxin B - therapeutic use; polymyxin B sulfate; Polysporin; seborrheic keratoses; Skin Irritancy Tests; superficial wounds; Treatment Outcome; wound care; wound healing; Wound Healing - drug effects
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2010.11.010

Background Topical antibiotic ointments are commonly used for the postprocedural treatment of superficial wounds created during dermatologic procedures. We propose that antibiotics may not be necessary for healing these wounds, have the potential to cause allergic contact dermatitis, and may contribute to the development of antibiotic resistance. Objective We sought to compare the efficacy and safety of a nonantibiotic, petrolatum-based ointment (Aquaphor Healing Ointment [AHO], Beiersdorf Inc, Wilton, CT) and an antibiotic-based first-aid ointment (Polysporin [Poly/Bac], Johnson & Johnson, New Brunswick, NJ) for the treatment of wounds created by removal of seborrheic keratoses. Methods In this double-blind study, 30 subjects each had two seborrheic keratoses removed from their trunk or abdomen; one wound was treated with AHO and one with Poly/Bac twice daily. Clinical grading of wound healing and subjective irritation was assessed at days 7, 14, and 28 postwounding. Adverse events were recorded. Results Clinical grading assessment showed no differences between wounds treated with AHO versus Poly/Bac for erythema, edema, epithelial confluence, crusting, and scabbing at any time point. Subjective irritation assessment showed wounds treated with Poly/Bac had a significant increase in burning at week 1, whereas no differences were seen between treatments for stinging, itching, tightness, tingling, or pain. One case of allergic contact dermatitis was reported after Poly/Bac treatment. Limitations This was a relatively small study. Conclusions This study demonstrated that the petrolatum-based skin protectant ointment AHO provided equivalent efficacy for wound healing as a combination antibiotic first-aid ointment. Antibiotics may not be necessary to achieve satisfactory wound healing and may cause allergic contact dermatitis.