What ointment is recommended for a laceration?

Recommended Ointment for Laceration Care

For laceration care, mupirocin 2% topical ointment is recommended as the first-line treatment, particularly for minor wounds and secondarily infected skin lesions including lacerations. 1

Evidence-Based Approach to Laceration Care

Topical Antimicrobial Treatment

• Mupirocin 2% topical ointment is specifically recommended in clinical practice guidelines for minor skin wounds and secondarily infected skin lesions, including lacerations 1
• Application instructions:
  • Clean the affected area thoroughly first
  • Apply a small amount (equivalent to the surface area of a fingertip) to the laceration
  • Apply 1-3 times daily
  • May be covered with a sterile bandage 2

Wound Management Protocol

1. Initial wound care:

   • Thoroughly irrigate the wound with potable water to remove foreign material 1
   • Ensure complete cleansing with irrigation under pressure 3
   • Examine for any deep structure involvement that would require specialized care

2. Wound closure considerations:

   • Ensure accurate approximation of the dermal layer for optimal strength 3
   • For simple lacerations, consider:
     • Sutures for higher-tension areas
     • Tissue adhesives or wound adhesive strips for low-tension areas 4

3. Post-closure care:

   • Apply mupirocin 2% ointment to the wound 1
   • Cover with a clean occlusive dressing to improve healing and reduce pain 1
   • Maintain a moist healing environment with occlusive or semi-occlusive dressings 4

Important Clinical Considerations

Antibiotic Use

• Topical antibiotics: Wounds heal better with less infection when covered with antibiotic ointment and a clean occlusive dressing 1
• Systemic antibiotics: Not routinely recommended for simple lacerations
  • Multiple studies show no significant benefit of prophylactic systemic antibiotics for simple hand lacerations 5, 6, 7
  • In one study with 265 patients, only 1.1% infection rate was observed with no difference between antibiotic and placebo groups 7

Special Populations

• Pediatric patients: Mupirocin 2% topical ointment is also recommended for children with minor skin infections and secondarily infected skin lesions 1

Follow-up Care

• Examine the wound a few days after closure for signs of infection 3
• Sitz baths twice daily until first wound check may be beneficial for certain wounds 1

Pitfalls to Avoid

• Do not apply ice directly to a wound as it can produce tissue ischemia 1
• Avoid using tetracyclines in children under 8 years of age 1
• Do not leave wounds uncovered; occlusive dressings promote faster healing 4
• Avoid excessive tension when closing wounds, which can lead to tissue necrosis and poor healing

The evidence strongly supports that proper wound cleaning, appropriate closure technique, and application of mupirocin 2% topical ointment with proper dressing provides optimal outcomes for laceration care while minimizing infection risk.