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ARTICLE |

Infection and Allergy Incidence in Ambulatory Surgery Patients Using White Petrolatum vs Bacitracin Ointment:  A Randomized Controlled Trial

David Phillips Smack, MC; Allan C. Harrington, MC; Cary Dunn, MC; Robin S. Howard, MA; Albert J. Szkutnik; Steven J. Krivda, MC; James B. Caldwell, MC; William D. James, MC
JAMA. 1996;276(12):972-977. doi:10.1001/jama.1996.03540120050033.
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Objective.  —To assess the effect of white petrolatum vs bacitracin ointment on wound infection incidence, allergic contact dermatitis incidence, and healing characteristics.

Design.  —Randomized,double-blind, prospective trial comparing white petrolatum with bacitracin ointment in postprocedure wound care.

Setting.  —A general outpatient dermatology clinic and a tertiary referral advanced surgical procedure clinic at Walter Reed Army Medical Center, Washington, DC.

Patients.  —A total of 922 patients who had dermatologic surgery with a total of 1249 wounds.

Main Outcome Measures.  —The incidence of infection and allergic contact dermatitis during a follow-up period of 4 weeks. Healing characteristics were secondary outcomes.

Results.  —Of the 922 patients enrolled, 440 in the white petrolatum group and 444 in the bacitracin group were evaluable for clinical response. The 2 treatment groups had comparable baseline characteristics. Thirteen patients developed postprocedure infection (1.5%), 9 (2.0%) in the white petrolatum group vs 4 (0.9%) in the bacitracin group (95%) confidence interval for difference, -0.4% to 2.7%; P=.37). Eight infections (1.8%) in the white petrolatum group were due to Staphylococcus aureusvs none in the bacitracin group (P=.004). No patient in the group using white petrolatum developed allergic contact dermatitis vs 4 patients (0.9%) in the group using bacitracin (P=.12). Additionally, there were no clinically significant differences in healing between the treatment groups on day 1 (P=.98), day 7 (P=.86), or day 28 (P=.28) after the procedure.

Conclusions.  —White petrolatum is a safe, effective wound care ointment for ambulatory surgery. In comparison with bacitracin, white petrolatum possesses an equally low infection rate and minimal risk for induction of allergy.

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