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.
OBJECTIVE
To determine the effectiveness of a single application of topical chloramphenicol ointment in preventing wound infection after minor dermatological surgery.


METHODS
Prospective randomised placebo controlled double blind multicentre trial.


METHODS
Primary care in a regional centre in Queensland, Australia.


METHODS
972 minor surgery patients.


METHODS
A single topical dose of chloramphenicol (n=488) or paraffin ointment (n=484; placebo).


METHODS
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.


CONCLUSIONS
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.
Heal
Clare F
CF
James Cook University, School of Medicine, Mackay Base Hospital, Queensland 4740, Australia. clare.heal@jcu.edu.au
Buettner
Petra G
PG
Cruickshank
Robert
R
Graham
David
D
Browning
Sheldon
S
Pendergast
Jayne
J
Drobetz
Herwig
H
Gluer
Robert
R
Lisec
Carl
C
D000287:Administration, Topical; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis; D002701:Chloramphenicol / Q000008:administration & dosage*; D004311:Double-Blind Method; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011552:Pseudomonas Infections / Q000517:prevention & control*; D011550:Pseudomonas aeruginosa; D012878:Skin Neoplasms / Q000601:surgery; D013203:Staphylococcal Infections / Q000517:prevention & control*; D013211:Staphylococcus aureus; D013530:Surgical Wound Infection / Q000517:prevention & control*; D013536:Suture Techniques; D016896:Treatment Outcome
D000891:Anti-Infective Agents, Local; D002701:Chloramphenicol