Infection and allergy incidence in ambulatory surgery patients using white petrolatum vs bacitracin ointment. A randomized controlled trial.
OBJECTIVE
To assess the effect of white petrolatum vs bacitracin ointment on wound infection incidence, allergic contact dermatitis incidence, and healing characteristics.


METHODS
Randomized, double-blind, prospective trial comparing white petrolatum with bacitracin ointment in postprocedure wound care.


METHODS
A general outpatient dermatology clinic and a tertiary referral advanced surgical procedure clinic at Walter Reed Army Medical Center, Washington, DC.


METHODS
A total of 922 patients who had dermatologic surgery with a total of 1249 wounds.


METHODS
The incidence of infection and allergic contact dermatitis during a follow-up period of 4 weeks. Healing characteristics were secondary outcomes.


RESULTS
Of the 922 patients enrolled, 440 in the white petrolatum group and 444 in the bacitracin group were evaluable for clinical response. The 2 treatment groups had comparable baseline characteristics. Thirteen patients developed postprocedure infection (1.5%), 9 (2.0%) in the white petrolatum group vs 4 (0.9%) in the bacitracin group (95% confidence interval for difference, -0.4% to 2.7%; P=.37). Eight infections (1.8%) in the white petrolatum group were due to Staphylococcus aureus vs none in the bacitracin group (P=.004). No patient in the group using white petrolatum developed allergic contact dermatitis vs 4 patients (0.9%) in the group using bacitracin (P=.12). Additionally, there were no clinically significant differences in healing between the treatment groups on day 1 (P=.98), day 7 (P=.86), or day 28 (P=.28) after the procedure.


CONCLUSIONS
White petrolatum is a safe, effective wound care ointment for ambulatory surgery. In comparison with bacitracin, white petrolatum possesses an equally low infection rate and minimal risk for induction of allergy.
Smack
D P
DP
Department of Dermatology, Walter Reed Army Medical Center, Washington, DC, USA.
Harrington
A C
AC
Dunn
C
C
Howard
R S
RS
Szkutnik
A J
AJ
Krivda
S J
SJ
Caldwell
J B
JB
James
W D
WD
D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000191:economics / Q000706:statistics & numerical data; D000891:Anti-Infective Agents, Local / Q000191:economics / Q000627:therapeutic use*; D001414:Bacitracin / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D017449:Dermatitis, Allergic Contact / Q000191:economics / Q000453:epidemiology* / Q000209:etiology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010577:Petrolatum / Q000191:economics / Q000627:therapeutic use*; D011182:Postoperative Care; D011446:Prospective Studies; D012871:Skin Diseases / Q000601:surgery*; D013530:Surgical Wound Infection / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control; D014945:Wound Healing / Q000187:drug effects
D000891:Anti-Infective Agents, Local; D001414:Bacitracin; D010577:Petrolatum