Does single application of topical chloramphenicol to high risk sutured wounds reduce incidence of wound infection after minor surgery? Prospective randomised placebo controlled double blind trial

• Published in: BMJ 2009-01, Vol.338 (7688), p.211-214
• Main Authors: Heal, Clare F, Buettner, Petra G, Cruickshank, Robert, Graham, David, Browning, Sheldon, Pendergast, Jayne, Drobetz, Herwig, Gluer, Robert, Lisec, Carl
• Format: Article
• Language: English
• Subjects: Administration, Topical; Anemia; Anti-Infective Agents, Local - administration & dosage; Antibiotic Prophylaxis; Antibiotics; Chloramphenicol; Chloramphenicol - administration & dosage; Control groups; Dermatology; Disease prevention; Dosage; Double-Blind Method; Drug Resistance, Microbial; Female; Humans; Infection; Infections; Lesions; Male; Middle Aged; Minimally Invasive Surgical Procedures; Minor surgical procedures; Nosocomial infections; Nurses; Ointment bases; Ointments; Patients; Placebos; Practice nursing; Preventive programmes; Pseudomonas aeruginosa; Pseudomonas Infections - prevention & control; Skin cancer; Skin Neoplasms - surgery; Staphylococcal Infections - prevention & control; Staphylococcus aureus; Surgery; Surgical Wound Infection - prevention & control; Surveillance; Suture Techniques; Sutures; Treatment Outcome; Wound healing; Wound infections
• ISSN: 0959-8138; 0959-535X; 1468-5833; 1756-1833
• DOI: 10.1136/bmj.a2812

Objective To determine the effectiveness of a single application of topical chloramphenicol ointment in preventing wound infection after minor dermatological surgery.Design Prospective randomised placebo controlled double blind multicentre trial.Setting Primary care in a regional centre in Queensland, Australia.Participants 972 minor surgery patients.Interventions A single topical dose of chloramphenicol (n=488) or paraffin ointment (n=484; placebo).Main outcome measure Incidence of infection.Results The incidence of infection in the chloramphenicol group (6.6%; 95% confidence interval 4.9 to 8.8) was significantly lower than that in the control group (11.0%; 7.9 to 15.1) (P=0.010). The absolute reduction in infection rate was 4.4%, the relative reduction was 40%, and the relative risk of wound infection in the control group was 1.7 (95% confidence interval 1.1 to 2.5) times higher than in the intervention group. The number needed to treat was 22.8.Conclusion Application of a single dose of topical chloramphenicol to high risk sutured wounds after minor surgery produces a moderate absolute reduction in infection rate that is statistically but not clinically significant.Trial registration Current Controlled Trials ISRCTN73223053.