What type of ointment can I apply to a laceration?

Ointment Options for Laceration Care

For simple lacerations, applying antibiotic ointment with a clean occlusive dressing is recommended as it improves healing and reduces infection risk. 1

First-Line Ointment Options

• Mupirocin 2% ointment is highly effective for minor skin lacerations and should be applied three times daily to the affected area, which may be covered with a gauze dressing if desired 2
• For children with minor lacerations or secondarily infected skin lesions, mupirocin 2% topical ointment is specifically recommended 1
• White petrolatum ointment (Vaseline) is as effective as antibiotic ointment for post-procedure wound care, making it a cost-effective alternative 3

Application Technique

• Apply a small amount of the chosen ointment directly to the laceration 2
• Cover with a clean occlusive or semi-occlusive dressing to maintain a moist environment, which promotes faster healing 4
• For deeper or more complex lacerations, ensure the wound is thoroughly irrigated with potable water before applying any ointment 1

Special Considerations

• For open wounds requiring anesthesia before treatment, topical anesthetic options include:

  • LET (lidocaine, epinephrine, and tetracaine) mixture provides excellent wound anesthesia in 20-30 minutes 1
  • EMLA cream can provide topical anesthesia for laceration repair, though not FDA-approved specifically for this purpose 1

• For contaminated wounds:

  • Thoroughly irrigate with a large volume of warm or room temperature potable water with or without soap until there is no foreign matter in the wound before applying any ointment 1
  • Consider antibiotic ointment rather than petrolatum for wounds with higher infection risk (diabetic patients, lower extremity wounds, contaminated wounds, or lacerations >5cm) 5

Wound Closure Considerations

• For low-tension wounds, consider:
  • Tissue adhesives (such as octyl cyanoacrylate) for essentially painless closure 1
  • Wound adhesive strips (Steri-Strips) which provide similar painless closure at lower cost 1
  • Using these methods may reduce ED length of stay compared to traditional sutures/staples 6

Follow-up Care

• Monitor the wound for signs of infection for up to 30 days 5
• If no clinical improvement is seen within 3-5 days of antibiotic ointment application, the wound should be re-evaluated 2
• Contrary to traditional teaching, time from injury to wound closure (up to 12 hours or more) does not significantly impact infection rates with proper wound care 5, 7

Important Cautions

• Avoid applying ice directly to wounds as it can produce tissue ischemia 1
• For patients with diabetes, lower extremity lacerations, contaminated wounds, or lacerations greater than 5 cm, be especially vigilant about infection prevention as these factors increase infection risk 5