Recommended Ointment for Bedsores
Use hydrocolloid or foam dressings rather than traditional ointments for treating pressure ulcers, as these are the evidence-based recommendations from the American College of Physicians. 1
Primary Treatment Approach
The 2015 ACP guidelines specifically recommend hydrocolloid or foam dressings over gauze dressings for reducing wound size in pressure ulcers 1. These are not traditional "ointments" but rather specialized wound dressings that create an optimal healing environment.
Why Dressings Over Ointments?
- Hydrocolloid dressings demonstrated superior wound size reduction compared to gauze dressings
- Foam dressings (hydrocellular or polyurethane) showed equivalent complete wound healing rates to hydrocolloid dressings
- Both options are more cost-effective than advanced biological agents while maintaining clinical effectiveness 1
Specific Ointment Options (When Debridement Needed)
If you're specifically looking for an ointment-based product, clostridial collagenase ointment has the strongest evidence:
- Collagenase ointment as an adjunct to selective debridement showed 2x greater wound closure rates for Stage IV pressure ulcers compared to selective debridement alone 2
- More cost-effective than hydrogel alternatives, with 3.2 times lower cost per granulation day ($78 vs $249) 3
- Particularly useful when necrotic tissue requires enzymatic debridement
Avoid These Options
Do not use:
- Dextranomer paste - shown to be inferior to other dressings for reducing wound size 1
- Plain gauze dressings - less effective than hydrocolloid alternatives 1
Important Caveats
Common Pitfalls to Avoid:
- Skin irritation, inflammation, and tissue maceration are the most commonly reported harms with topical wound applications 1
- Monitor closely for these complications regardless of which product you choose
- The evidence focuses on wound size reduction rather than complete healing - the relationship between these outcomes remains poorly defined 1
Adjunctive Considerations:
While not ointments, the guidelines also recommend:
- Protein or amino acid supplementation to reduce wound size (though evidence is limited to patients with nutritional deficiencies) 1
- Electrical stimulation as adjunctive therapy to accelerate healing 1
Emerging Evidence (Use With Caution)
Recent studies suggest potential benefit from:
- 25% zinc oxide cream for Stage I-II ulcers (2025 data shows 83% partial healing by day 14) 4
- However, this lacks the guideline-level evidence of hydrocolloid/foam dressings
The bottom line: Start with hydrocolloid or foam dressings as your primary approach. Reserve collagenase ointment for wounds requiring enzymatic debridement of necrotic tissue.