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September 25, 1996

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

Author Affiliations

From the Departments of Dermatology (MAJ Smack, MAJ Harrington, MAJ Dunn, MAJ Krivda, MAJ Caldwell, and COL James), Clinical Investigation (Ms Howard), and Pharmacy (Mr Szkutnik), Walter Reed Army Medical Center, Washington, DC. MAJ Smack is now Chief of the Dermatology Service, Womack Army Medical Center, Ft Bragg, NC. Dr James is now with the Department of Dermatology, University of Pennsylvania, Philadelphia.

JAMA. 1996;276(12):972-977. doi:10.1001/jama.1996.03540120050033

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.