A Fly In The Ointment

Antibiotic ointment, a basic element of every first-aid kit, has gotten a bad rap lately. You may have heard reports that ointment does nothing to prevent infection, and that it may even be counterproductive.

It’s true that a clean shallow wound probably will heal fine without the ointment, but using antibiotic ointment will speed up the process by preventing scab formation. Having a scab covering a wound was better than nothing before the age of Band-Aids, but scabs are generally viewed as a detriment today. They slow healing and trap debris, increasing the risk of infection. In addition, a slower healing rate often leads to scar formation.

“Ointment (applied to a wound) generates a moist, receptive environment for new cells,” says Garth Russo, M.D., an acute-care physician at the University of Georgia. In other words, you’ll heal faster. But if a wound is deep, don’t smear ointment inside it. Instead, copiously irrigate the wound, close it with strips of tape or closure strips, then apply ointment to the surface only. (Don’t close a wound that gapes open more than half an inch. Clean it, pack it open with sterile gauze, cover it, and get to a doctor.)

What kind of ointment is best? Any over-the-counter preparation will speed healing, but choose those “least likely to generate toxicity,” such as an allergic reaction, says Dr. Russo. Some people are allergic to neomycin. That’s why many docs recommend using a “double” antibiotic ointment containing polymyxin and bacitracin, instead of a “triple” antibiotic ointment containing neomycin as well. Check the ingredients before you buy.