Randomized clinical trial of the effect of applying ointment to surgical wounds before occlusive dressing

Abstract

Putting ointment on a surgical wound before occlusive dressing does not benefit the patient. In view of the risk of antibiotic resistance, mupirocin ointment is not indicated for clean surgical wounds.

Surgical antimicrobial prophylaxis

“…26 An earlier Australian randomised controlled trial including 1801 surgical wounds found no significant benefit from mupirocin or paraffin ointments before occlusive dressings when compared to no ointment use. 27 …”

Prospective study of long-term patient perceptions of their skin cancer surgery

“…We have previously described a 9.8% incidence of neutral or negative response to long-term scar appearance. 1 Others have described a similar 13% neutral or negative wound assessment after excision of basal cell carcinoma. 2 Skin cancer is still predominantly managed by surgical excision and repair, and cosmetic outcomes from such procedures are usually well accepted, even in comparison with nonoperative procedures such as radiotherapy.…”

“…2 Using a randomized trial format, the authors have previously demonstrated that the application of ointment to a wound does not change the overall patient assessment of cosmetic outcome. 1 Many other wound management methods have been adopted with the hope of improving scars but have shown no significant benefit in formal randomized control trials. 3,4 Wounds repaired under some tension are predominantly closed with sutures, with similar or somewhat improved results when compared with wounds closed with glues, [5][6][7][8][9] staples, 10,11 or tapes.…”

Antibiotic Resistance Considerations of Importance to Clinical Dermatologists

“…59 Available evidence suggests that routine postsurgical use of a topical antibiotic is not recommended overall after office-based dermatologic procedures, especially those that are not at high risk of infection; this includes clean and cleancontaminated wounds, after procedures in patients that are immunocompetent and not at high risk of infection, after surgeries performed in regions above the knee, and after surgeries not involving the groin, ears, or mucosal region of the nose or mouth. 14, 52,60,61 In selected cases where the risk of post-operative infection is deemed to be high and avoidance of infection is a major priority due to patient-related risk factors, it is believed to be a better choice to utilize oral antibiotic prophylaxis as topical therapy alone is not as likely to provide adequate prevention of infection in such cases.…”