What are the appropriate topical treatments for open wound management to promote routine healing?

From the Guidelines

Topical treatments for open wound management should focus on maintaining a moist wound healing environment and controlling exudate, rather than using antimicrobial or antiseptic dressings.

Key Principles

• Clean ulcers regularly with clean water or saline
• Debride them when possible to remove debris from the wound surface
• Dress them with a sterile, inert dressing to control excessive exudate and maintain a warm, moist environment to promote healing 1

Recommended Topical Treatments

• Sterile, inert dressings to absorb exudate and maintain a moist wound healing environment 1
• Dressings that control exudate and maintain a warm, moist environment to promote healing 1

Not Recommended

• Topical antiseptic or antimicrobial dressings, as they have not been shown to improve wound healing or prevent secondary infection 1
• Honey or bee-related products, as there is little evidence to support their use for wound healing 1
• Herbal remedies, as the evidence is of poor quality and does not support their use for wound healing 1
• Collagen or alginate dressings, as there is no evidence to support their use for wound healing 1
• Topical phenytoin, as there is no evidence to support its use for wound healing 1

From the Research

Topical Treatments for Open Wound Management

The following are some of the topical treatments that can be used to promote routine healing of open wounds:

• Occlusive dressings, which are most useful for split-thickness wounds and full-thickness wounds allowed to heal by secondary intention 2
• Topical antibiotic ointments, such as Polysporin, which are safe to use on open wounds and effective in preventing wound infections 2
• Topical therapeutic agents, such as platelet-derived growth factors, which can assist in less complicated healing and decrease the conversion of a partial-thickness injury to a full-thickness injury 3, 4
• Dressings and topical agents, such as hydrogel dressings, platelet-rich plasma, and Lietofix cream, which may increase the proportion of wounds that heal by 30 days and reduce time to wound healing 5

Characteristics of Effective Topical Treatments

Effective topical treatments for open wound management should:

• Create an environment favorable to repair, such as a clean, moist, insulated, and protected environment 6
• Be individualized to the specific wound type and patient needs 4
• Be based on clinical merit and effectiveness as documented in the medical literature 4

Limitations of Current Evidence

The current evidence on the effectiveness of topical treatments for open wound management is limited by:

• High risk of bias in many studies 5
• Low-certainty evidence for many interventions 5
• Limited data on secondary outcomes, such as time to return to normal daily activities and recurrence rate 5
• Need for further studies to investigate the effectiveness of various topical treatments 5