A Pilot Study to Investigate the Efficacy of Tobramycin–Dexamethasone Ointment in Promoting Wound Healing
The standard postsurgical treatment of wounds after dermatologic procedures is currently limited. Topical corticosteroids have been used successfully in postoperative management of ophthalmologic surgeries that involve the skin of the eyelid. In particular, tobramycin 0.3%/dexamethasone 0.1% ophthalmic ointment is considered the “gold standard” of steroid-antibiotic fixed combinations and is marketed worldwide as an agent used to control postsurgical inflammation and prevent postsurgical infection. The purpose of this study is to evaluate both the efficacy and safety of tobramycin–dexamethasone ointment for the postsurgical management of Mohs or dermatologic surgery in comparison to white petrolatum.
The authors employed a half-scar study in which patients who underwent skin cancer removal surgery were given tobramycin–dexamethasone ointment and white petrolatum to apply to each half of their wound for 2 weeks. The study was double blinded, and physicians and the patients independently evaluated the scars for cosmetic appearance at 2 and 6 weeks postoperatively. The evaluation criteria included judging which side of the wound looked better based on color, thickness, and discomfort.
Eighteen patients were enrolled, of which 13 patients completed the three phases of the study. After 6 weeks the wounds did not show a statistically significant difference in color, thickness, or discomfort on either side.
Results obtained to date suggest that the application of tobramycin–dexamethasone ointment to wounds after dermatologic surgery does not promote better wound healing than white petrolatum. These findings indicate that a topical steroid and antibiotic ointment may not be an effective intervention in improving postoperative outcomes in dermatologic surgeries.
- Brown BC, McKenna SP, Siddhi K, McGrouther DA, Bayat A. The hidden cost of skin scars: quality of life after skin scarring. J Plast Reconstr Aesthet Surg. 2008;61:1049–58. CrossRef
- Sheth VM, Weitzul S. Postoperative topical antimicrobial use. Dermatitis. 2008;19:181–9.
- Drucker CR. Update on topical antibiotics in dermatology. Dermatol Ther. 2012;25:6–11. CrossRef
- Scoper SV, Kabat AG, Owen GR, et al. Ocular distribution, bactericidal activity and settling characteristics of TobraDex ST ophthalmic suspension compared with TobraDex ophthalmic suspension. Adv Ther. 2008;25:77–88. CrossRef
- Rhee SS, Mah FS. Comparison of tobramycin 0.3%/dexamethasone 0.1% and tobramycin 0.3%/loteprednol 0.5% in the management of blepharo-keratoconjunctivitis. Adv Ther. 2007;24:60–7. CrossRef
- Russo S, Papa V, Di Bella A, et al. Dexamethasone-netilmicin: a new ophthalmic steroid-antibiotic combination. Efficacy and safety after cataract surgery. Eye (Lond). 2007;21:58–64.
- Sobol SE, Keswani S, Parvadia JK, Crombleholme T, Potsic WP. Effect of corticosteroid-antibiotic agents on granulation tissue in a murine model. Arch Otolaryngol Head Neck Surg. 2005;131:330–5. CrossRef
- Baumann LS, Spencer J. The effects of topical vitamin E on the cosmetic appearance of scars. Dermatol Surg. 1999;25:311–5. CrossRef
- Draaijers LJ, Tempelman FR, Botman YA, et al. The patient and observer scar assessment scale: a reliable and feasible tool for scar evaluation. Plast Reconstr Surg. 2004;113:1960–5 (discussion 6–7).
- Van de Kar AL, Corion LU, Smeulders MJ, Draaijers LJ, Van der Horst CM, Van Zuijlen PP. Reliable and feasible evaluation of linear scars by the Patient and Observer Scar Assessment Scale. Plast Reconstr Surg. 2005;116:514–22. CrossRef
- Bayat A, McGrouther DA, Ferguson MW. Skin scarring. BMJ. 2003;326:88–92. CrossRef
- Oishi Y, Fu ZW, Ohnuki Y, Kato H, Noguchi T. Molecular basis of the alteration in skin collagen metabolism in response to in vivo dexamethasone treatment: effects on the synthesis of collagen type I and III, collagenase, and tissue inhibitors of metalloproteinases. Br J Dermatol. 2002;147:859–68. CrossRef
- Draelos ZD, Rizer RL, Trookman NS. A comparison of postprocedural wound care treatments: do antibiotic-based ointments improve outcomes? J Am Acad Dermatol. 2011;64(3 Suppl.):S23–9. CrossRef
- A Pilot Study to Investigate the Efficacy of Tobramycin–Dexamethasone Ointment in Promoting Wound Healing
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
Dermatology and Therapy
- Online Date
- August 2012
- Print ISSN
- Online ISSN
- Springer Healthcare Communications
- Additional Links
- Half scar
- Wound healing
- Industry Sectors