Heal, Clare F., Buettner, Petra G., Cruickshank, Robert, Graham, David, Browning, Sheldon, Pendergast, Jayne, Drobetz, Herwig, Gluer, Robert, and Lisec, Carl (2009) 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. British Medical Journal, 338 (7688). a2812.

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Abstract

Objective: To determine the effectiveness of a single application of topical chloramphenicol ointment in preventing wound infection after minor dermatological surgery.

Design: Prospective randomised placebo controlled double blind multicentre 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 significantly lower 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 relative reduction was 40%, and the relative risk of wound infection in the control group was 1.7 (95% confidence interval 1.1 to 2.5) times higher than in the intervention group. The number needed to treat was 22.8.

Conclusion: Application of a single dose of topical chloramphenicol to high risk sutured wounds after minor surgery produces a moderate absolute reduction in infection rate that is statistically but not clinically significant.

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