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

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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.

Section snippets

Methods

This 4-week, double-blind, multicenter trial enrolled men and women with Fitzpatrick skin types I, II, or III. All subjects were required to have two SK located on opposite sides of the front of their chest or abdomen 6 to 10 mm in size. Subjects with any disease state or inappropriate physical skin condition that might impair evaluations or increase the individual’s health risk or with any known allergy or sensitivity to test materials were excluded.

Selected SK sites were cleaned with alcohol,

Results

A total of 30 subjects aged 50 to 83 years (mean, 61 years) completed this study. All participants were Caucasian with Fitzpatrick skin type I (26.7%), II (63.3%), or III (10.0%). The majority of study participants were female (76.7%).

Clinical grading assessment showed no differences between wounds treated with AHO versus Poly/Bac for the wound-healing parameters of erythema, edema, epithelial confluence, crusting, and scabbing at any time point (Fig 1).

For the subjective irritation

Discussion

This study demonstrated that equivalent healing of wounds was achieved using an antibiotic-free ointment compared with an antibiotic-based topical ointment. AHO and Poly/Bac treatment resulted in equivalent healing for all clinical and subjective irritation parameters. This was not unexpected, as both products have a similar petrolatum base, which provides a protective moist environment that facilitates re-epithelialization and wound healing. Petrolatum is classified by the Food and Drug

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    Publication of this article was supported by Beiersdorf Inc.

    Disclosure: Dr Draelos has been a consultant for Beiersdorf Inc, Merz Pharmaceuticals, and Johnson & Johnson. Dr Rizer has been a consultant for Johnson & Johnson. Dr Trookman is a consultant for Thomas J. Stephens & Associates.

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