Does single application of topical chloramphenicol to high risk sutured wounds reduce incidence of wound infection after minor surgery? Prospective randomised placebo controlled double blind trial

doi:10.1136/bmj.a2812

Published 15 January 2009, doi:10.1136/bmj.a2812
Cite this as: BMJ 2009;338:a2812

Research

Does single application of topical chloramphenicol to high risk sutured wounds reduce incidence of wound infection after minor surgery? Prospective randomised placebo controlled double blind trial

Clare F Heal, senior lecturer¹, Petra G Buettner, senior lecturer², Robert Cruickshank, general practitioner³, David Graham, general practitioner³, Sheldon Browning, general practitioner⁴, Jayne Pendergast, practice nurse³, Herwig Drobetz, staff orthopaedic surgeon⁵, Robert Gluer, medical student¹, Carl Lisec, surgical registrar⁶

¹ James Cook University, School of Medicine, Mackay Base Hospital, Queensland 4740, Australia, ² James Cook University, Queensland 4811, ³ Walkerston Medical Centre, Mackay, Queensland 4740, ⁴ Molescan, Mackay, Queensland 4740, ⁵ Mackay Base Hospital, Queensland 4740, ⁶ Townsville General Hospital, Queensland 4740

Correspondence to: C F Heal clare.heal{at}jcu.edu.au

Objective To determine the effectiveness of a single applicationof topical chloramphenicol ointment in preventing wound infectionafter minor dermatological surgery.

Design Prospective randomised placebo controlled double blindmulticentre trial.

Setting Primary care in a regional centre in Queensland, Australia.

Participants 972 minor surgery patients.

Interventions A single topical dose of chloramphenicol (n=488)or paraffin ointment (n=484; placebo).

Main outcome measure Incidence of infection.

Results The incidence of infection in the chloramphenicol group(6.6%; 95% confidence interval 4.9 to 8.8) was significantlylower than that in the control group (11.0%; 7.9 to 15.1) (P=0.010).The absolute reduction in infection rate was 4.4%, the relativereduction was 40%, and the relative risk of wound infectionin the control group was 1.7 (95% confidence interval 1.1 to2.5) times higher than in the intervention group. The numberneeded to treat was 22.8.

Conclusion Application of a single dose of topical chloramphenicolto high risk sutured wounds after minor surgery produces a moderateabsolute reduction in infection rate that is statistically butnot clinically significant.

Trial registration Current Controlled Trials ISRCTN73223053 [controlled-trials.com] .

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This article has been cited by other articles:

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Read all Rapid Responses

Antibiotic Prophylaxis in Dermatological Surgery: Richard J Motley
bmj.com, 24 Jan 2009 [Full text]
Post operative infection rate requires investigation: Bo Povlsen
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Is topical Chloramphenicol necessary to reduce wound infections?: David L Wallace
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re topical chloramphenicol: Clare Heal, et al.
bmj.com, 15 Feb 2009 [Full text]