What ointment is recommended for dressing wounds?

Recommended Ointments for Wound Dressing

For clean superficial wounds and abrasions, use plain petrolatum or petrolatum-based ointments under an occlusive dressing; antibiotic ointments are not necessary and do not improve healing outcomes. 1

General Wound Care Approach

Clean Superficial Wounds and Abrasions

• Use occlusive dressings with petrolatum-based products (such as plain petrolatum, hydrogel, or film dressings) to maintain a moist wound healing environment 1
• Avoid routine use of antibiotic ointments - there is no evidence that antibiotic or antibacterial dressings improve wound healing or decrease infection rates in clean wounds 1
• Plain petrolatum is preferred over antibiotic-containing ointments because it avoids the risk of allergic contact dermatitis and antibiotic resistance without compromising healing 2

Thermal Burns (Partial-Thickness)

For small partial-thickness burns managed at home, after cooling, apply petrolatum, petrolatum-based antibiotic ointment (such as polymyxin), honey, or aloe vera with a clean nonadherent dressing. 1

• Petrolatum-based products (with or without antibiotics like polymyxin) have been shown to improve healing time in partial-thickness burns 1
• Triple-antibiotic ointment enhances reepithelialization and reduces scarring compared to silver-based dressings 3, 4
• Honey and aloe vera are acceptable alternatives 1
• Avoid silver sulfadiazine for routine first aid - while FDA-approved for burns 5, antibiotic ointments demonstrate superior healing rates and less scarring in comparative studies 3, 4

Diabetes-Related Foot Ulcers

Do not use topical antiseptic, antimicrobial dressings, honey, collagen, or alginate dressings for diabetic foot ulcers - use basic dressings that absorb exudate and maintain a moist wound healing environment. 1

• No specific dressing type has been shown superior to simple gauze dressings for healing diabetic foot ulcers 1
• Heavy exudate wounds need moisture-absorbing dressings; dry wounds need moisture-adding treatments 1
• The only exception: consider sucrose-octasulfate impregnated dressing for non-infected, neuro-ischemic ulcers that fail standard care after 2 weeks 1

Key Clinical Pitfalls

Avoid These Common Mistakes:

• Do not use povidone-iodine for wound cleansing - it provides no benefit over tap water or saline irrigation 1
• Do not apply antibiotic ointments to diabetic foot ulcers - strong evidence shows no benefit 1
• Do not use Aquaphor Healing Ointment if concerned about wound redness - it causes higher incidence of wound redness (52%) compared to plain petrolatum (12%) 6
• Recognize allergic contact dermatitis risk with antibiotic ointments, particularly those containing neomycin 7, 2

When to Escalate Care:

• Animal or human bite wounds require immediate medical facility evaluation regardless of topical treatment 1
• Signs of infection (redness, swelling, foul drainage, increased pain, fever) warrant dressing removal, wound inspection, and medical care 1
• Burns involving face, hands, feet, genitals, or >10% body surface area (5% in children) require specialized burn center treatment 1

Practical Algorithm

For routine wound dressing selection:

1. Clean wound thoroughly with tap water or sterile saline (not antiseptics) 1
2. For clean superficial wounds: Apply plain petrolatum and occlusive dressing 1
3. For small partial-thickness burns: Apply petrolatum-based antibiotic ointment (e.g., bacitracin/polymyxin) or plain petrolatum with nonadherent dressing 1, 7
4. For diabetic foot ulcers: Use basic moisture-balancing dressings only; no topical antimicrobials 1
5. Change dressings at least daily for infected wounds to allow examination 1