Topical antibiotics, over-the-counter products, and standard gauze dressings: a review of postoperative surgical site infection and wound healing management

Philadelphia, PA

Proper wound healing and prevention of surgical site infections (SSI) are critical in postoperative patient care. According to the CDC, SSIs account for almost twenty percent of all healthcare-associated infections and cause an annual cost of an estimated $3.3 billion annually. Wound healing time, as well as cosmetic results, also play an important role in postoperative wound care. Currently there is not a consensus standard of care for topical treatments to address these issues. This study aims to explore various topical treatments that prevent SSI and encourage effective healing.

A search was conducted on PubMed using the algorithm: ([Vaseline] OR [Aquaphor] OR [Mupirocin] OR [Bacitracin]) AND ([Postoperative wound care] OR [Surgical wound] OR [Incision]). Inclusion criteria included full text primary articles published from 2010 to 2025. Exclusion criteria included duplicates, reviews, animal studies, and studies not pertaining to postoperative wound care. Five-hundred and seventy three full-text articles were retrieved. Following screening and exclusion, 15 articles underwent review.

A comprehensive review of the included studies resulted in 5 papers investigating postoperative infection rates, 9 papers analyzing postoperative wound healing, and 1 that encompassed both. Those studies examining SSIs presented mixed data regarding effectiveness of topical antibiotics compared to over the counter treatments. One study concluded that VE-silicone and mupirocin dressings are effective in preventing SSIs and another concluded that generally topical antibiotics lower the risk of SSIs compared to nonantibiotic ointment. However, the other four studies were not able to provide enough evidence to conclude whether antibiotic or nonantibiotic ointment was more effective in preventing SSIs. Among the 10 studies that evaluated postoperative wound healing, authors evaluated different combinations of healing, healing time, number of dressing changes, and cosmetic results. These papers studied various topical dressings and all but one concluded that applying a topical ointment postoperatively promotes wound healing.