Level 1: Likely reliable evidence
The use of sterile paraffin (Lacri-Lube) or mupirocin (Bactroban) ointment on surgical wounds was evaluated in a randomized trial and compared with no ointment (Br J Surg. 2006;93:937-943). Patients older than 18 years with a skin lesion requiring incisional or excisional surgery (N =778) were randomized to no ointment vs. sterile paraffin vs. mupirocin ointment before placement of a moist occlusive dressing. All wounds on a given patient received the same assigned treatment; 1,801 wounds were included and analyzed.
Comparing no ointment vs. sterile paraffin vs. mupirocin ointment in an analysis of all wounds, there were no significant differences in rates of physician-recorded infection (1.4% vs. 1.6% vs. 2.3%) or overall complications (3.5% vs. 4.7% vs. 4.8%). The rate of scar complications was increased with either ointment (0 vs. 0.7% vs. 1.2%, P =.044), mostly due to skin necrosis. There were no significant differences in rates of postoperative bleeding (1.2% vs. 0.5% vs. 0.4%), wound dehiscence (0.6% vs. 0.8% vs. 0.7%), and other complications (0.4% vs. 1% vs. 0.2%).
There were no significant differences in numbers of patients who had neutral or negative perception of their wound at six to nine months, based on follow-up of 74% of patients (10.9% vs. 10.3% vs. 8.2%). In an analysis of first wounds treated in all patients by unit of randomization, there were no significant differences in rate of skin infection (1.6% vs. 2.3% vs. 2.3%) and no differences in wound problems, bleeding, or total complications.