Atlanta — According to a recent study, placing ointment on surgical wounds before applying occlusive dressings provides no observable benefits; moreover, applying mupirocin ointment to clean surgical wounds is contraindicated given the potential for creating antibiotic resistance.
Atlanta - According to a recent study, placing ointment on surgical wounds before applying occlusive dressings provides no observable benefits; moreover, applying mupirocin ointment to clean surgical wounds is contraindicated given the potential for creating antibiotic resistance.
"In every case, the wound was one that had been cut and sutured together. The idea was to try and determine whether putting the ointment on actually provided any benefit to the patient. We know many doctors swear by (this practice), but it's never been studied before to see if it made any difference," says Anthony J. Dixon, M.D., senior lecturer in skin cancer at the University of Queensland, Australia, and lead author of the unpublished report.
"In many trials," Dr. Dixon says, "researchers focus only on what wounds look like when one removes sutures. But the aim of the game is clearly not just to see how pretty the wound is when sutures come out - it's how good the wound looks in the long term."
Dr. Dixon says, "It didn't. The infection rate was essentially the same in every group." Among patients who received no ointment, it was 1.4 percent, versus 1.6 percent in the mupirocin group and 2.3 percent in the paraffin-treated group (p=0.49).
As for patients' assessments six to nine months post-surgery, he adds, "all three groups' descriptions of the appearance of their wounds were amazingly similar." In this regard, 10.9 percent of patients in the no-ointment group reported neutral or negative perception of their wounds. By comparison, the corresponding figures in the mupirocin and paraffin groups were 10.3 percent and 8.2 percent, respectively (p=0.65).
Total complication rates (no ointment, 3.6 percent; mupirocin, 4.7 percent; paraffin, 4.8 percent; p=0.49) revealed a similar pattern, Dr. Dixon says. Nor did researchers observe any difference in postoperative pain, degree of inconvenience to patients and patients' satisfaction levels with medical services provided.
"Not one variation showed up. This shows for the first time that putting ointment on wounds appears to be a waste of time. Those who do it now need to consider stopping this practice, because the only major trial to see whether it has benefit has shown no benefit at all," Dr. Dixon says.
Accordingly, Dr. Dixon recommends simply applying dressing and tape to closed and cleaned wounds.
"If one puts on ointment," he says, "one is actually adding an extra step that's of no benefit to anyone, and costs the doctor money for the ointment, to the procedure."