Health :: Clean surgical wounds don’t need antibiotic cream

An ointment containing the antibiotic mupirocin does not speed healing or prevent infection when applied to clean surgical wounds before the wound is sealed, research suggests. In fact, the ointment may increase the risk of skin edge necrosis (death), an Australian research team found.

Mupirocin is effective in treating contaminated lesions and skin infections, and is widely advocated even when wounds are not contaminated, although there is little evidence to support the latter recommendation, according to Dr. Anthony Dixon, a dermasurgeon and skin cancer specialist from Skincanceronly in Belmont.

Moreover, there are data indicating a risk of mupirocin resistance that could reduce its effectiveness over time.

To investigate further, Dixon and colleagues studied 778 patients with a total of 1801 wounds. Following surgical treatment, 510 wounds were randomly assigned to no ointment, 729 to paraffin ointment, and 562 to mupirocin ointment. Patients were asked to complete and return surveys 6 months later to ascertain long-term outcomes.

The investigators observed no significant differences among the three groups in the number of wound infections, pain or wound discomfort, long-term cosmetic outcomes or overall complications.

However, Dixon’s group found it somewhat alarming that seven cases of skin necrosis occurred in the mupirocin group, versus one in the paraffin group and zero in the no-ointment group.

In a report in the British Journal of Surgery, they propose, “Existing advice regarding the role of ointments on wounds (largely antibiotic ointment) following skin lesion surgery and before dressing should be reviewed in the light of these findings.”

SOURCE: British Journal of Surgery, August 2006.


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