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


CONCLUSIONS
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.
Department of Dermatology, Duke University School of Medicine, Durham, NC 27262, USA. zdraelos@northstate.net
Zoe D
ZD
Draelos
Ronald L
RL
Rizer
Nathan S
NS
Trookman
D001414:Bacitracin / Q000627:therapeutic use*; D017449:Dermatitis, Allergic Contact / Q000209:etiology; D004311:Double-Blind Method; D004352:Drug Resistance, Microbial; D006801:Humans; D017492:Keratosis, Seborrheic / Q000601:surgery; D009824:Ointments / Q000627:therapeutic use*; D010577:Petrolatum / Q000627:therapeutic use*; D011112:Polymyxin B / Q000627:therapeutic use*; D023422:Skin Irritancy Tests; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects*
D009824:Ointments; C069612:bacitracin, polymyxin B drug combination; D001414:Bacitracin; D010577:Petrolatum; D011112:Polymyxin B