Antiseptic ointment and healing time

[bluebanded goby]

I've noticed that antiseptic/antibiotic ointments such as Bactroban are often suggested to promote healing of scrapes. In my own anecdotal experience, though, it seems that they can often slow healing; exposure to air (with occasional cleaning) usually seems to work the best for me.

Any thoughts on this? I realize that other factors (coral, obvious infection) can slow healing of scrapes; I'm talking about relatively uncomplicated cases.

 

[Bubbletrubble]

A better way to think of antibiotic ointment is that it's insurance against having an infection of a "scrape" as the wound heals on its own.

Bactroban contains mupirocin which is active against Gram-positive bacteria.
AFAIK, there's nothing in Bactroban that actually speeds up wound healing, per se.
I have seen some people develop an allergic reaction to an antibiotic ointment, which could certainly hinder the healing process. Not sure whether that was caused by the active ingredient or a component of the vehicle.

 

[DocVikingo]

Hi bluebanded goby,

The impact of topical antibacterial ointments on the healing speed of uninfected superficial wounds remains somewhat controversial, and can be argued either way with research support.

If one is going to use such an ointment for speeding wound healing/preventing infection, Bacitracin should be just as effective as Bacteroban (mupirocin), does not require a prescription, and most assuredly will be a whole lot cheaper.

Neosporin or triple antibiotic ointments containing it would also be expected to be just as, if not more effective than mupirocin, but carry a higher risk of allergic reaction.

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

 

[bluebanded goby]

Thanks for the comments. I remember one dive trip where I got a scrape that didn't look all that bad, but it worsened over a few days which prompted me to see a local doctor. He said he didn't think it was particularly infected, but he recommended staying out of the water until it cleared up. I regretted having to stay dry for the rest of that trip. Depending on the severity of the scrape, would ointment and a watertight bandage be one possibility to be able to stay in the water in a situation like that?

Re the different ointments, yes, I realize that Bactroban is prescription and somewhat more expensive -- I just happen to have some on hand. I've avoided triple antibiotic for several years now because I understand that neomycin can be ototoxic; even if it's unlikely at that level of exposure, I tend to get a lot of ear-ringing so I'd just as soon stay away from it.

 

[Bubbletrubble]

Depending on the severity of the scrape, would ointment and a watertight bandage be one possibility to be able to stay in the water in a situation like that?

Yes, provided that you can ensure the bandage is truly watertight and stays on the affected area during the water exposure. Getting a bandage to remain stuck to wet skin is a very difficult task, though. With a deep or large surface area wound, I wouldn't risk it.

Re the different ointments, yes, I realize that Bactroban is prescription and somewhat more expensive -- I just happen to have some on hand. I've avoided triple antibiotic for several years now because I understand that neomycin can be ototoxic; even if it's unlikely at that level of exposure, I tend to get a lot of ear-ringing so I'd just as soon stay away from it.

It's not just the level of dosage that matters. Route of administration counts as well.
AFAIK, the documented cases that reported aminoglycoside ototoxicity were from administration via oral, parenteral (IV), or topical application to the external ear canal (ear drops). The higher the dose, the higher the risk...but the incidence of ototoxicity is still low. The medical community is well aware of this complication of aminoglycoside therapy and has taken the necessary precautions in changing the formulations of ear drops. Synthesizing all of this info, topical administration of neomycin to the skin in a location away from the ear should have a very, very, very low risk of ototoxicity.

In fact, rather than your choice of topical antibiotic for cuts/scrapes on your arms/legs/hands, I'd be far more concerned about the cause and status of your ear-ringing.

 

[bluebanded goby]

In fact, rather than your choice of topical antibiotic for cuts/scrapes on your arms/legs/hands, I'd be far more concerned about the cause and status of your ear-ringing.

Thanks for the information -- I suspected as much about neomycin.

As for the tinnitus, mine has been well-studied, and I can mostly say what it isn't ... not related to noise, other trauma or illness, not Meniere's, not caused by a tumor. There is some thought it could be linked to inherited age-related hearing loss. On a positive note, all the docs say it's neither dive-related nor a reason not to dive.