A study published in the British Journal of Surgery in August of this year indicates that clean surgical wounds may not require any form of antibiotic cream to be applied to them post surgically. Dr. Anthony Dixon, a dermasurgeon and children’s skin cancer specialist, led a research study regarding the use of the antibiotic Mupirocin. This is a commonly used topical antibiotic ointment for post surgical wound healing. The researchers studied 778 patients with a total of 1,801 wounds as a result of surgical treatment. 510 wounds were randomly assigned no ointment at all, 729 were given a paraffin ointment and the remaining 562 used Mupirocin ointment, or the antibiotic ointment. Patients performed a six month follow-up survey to indicate the long terms affects of the three different forms of post-surgical treatment. The first thing I found very interesting about this article was that the researchers noted “no significant differences among the three groups” regarding the number of wound infections, pain or wound discomfort, and long-term cosmetic outcomes, along with overall complications. They did find it alarming that seven of the cases in the Mupirocin group suffered skin necrosis, or death of the tissue around the wound vs. one in the paraffin group and none in the no ointment group at all. This poses some interesting questions regarding post surgical care of a wound – is antibiotic cream or ointment necessary? It appears, at least from this preliminary study that the ointment has no beneficial effects and may actually have detrimental effects regarding the overall outcome of wound healing post-surgically. Obviously, this study needs to be followed up and further research is required, but the preliminary findings indicate that we may be better off just allowing a wound to heal with no subsequent treatment than applying an antibiotic ointment. The jury is still out, but this is some food for thought.
I am writing this article while I’m at a continuing education seminar in Atlanta, Georgia. I’ve been traveling a great deal recently, attending numerous classes and post doctoral education programs. As a result, I end up sleeping in a number of hotels. There are certain precautions that I have taken, and that you can take, to help with a problem that has become more of concern over recent years. This is something that we have not worried about, at least not in my lifetime. That is, bed bugs!
When I was a child, my dad used to tuck me in at night and say, “Goodnight, sleep tight, and don’t let the bed bugs bite.” I always thought it was kind of funny and thought that bed bugs were fictitious characters that existed in some fairy tale. In reality, bed bugs are insects which are approximately 4 mm long, and they have become more of a problem as a result of international travel and immigration to our country of individuals from countries where bed bugs are an epidemic.
There are a number of other causes of this problem one being that in recent years, and I can’t necessarily argue with this, some pesticides used to treat beds have been banned. One other thing which I find surprising is that recycled mattresses are being sold in this country. These reasons taken collectively are why bed bugs are becoming more and more of a problem for us, particularly in large cities.
Bed bugs are insects that bite humans and suck their blood as they sleep. They typically leave raised welts which tend to itch a great deal. Fortunately, most bed bugs do not carry any debilitating diseases such as Lyme disease which can be communicated to us from the deer tick. Once these insects are in your home, they are difficult to eliminate. So, the best policy is not to get them in your home.
Exterminators can be helpful. Sealing physical cracks in beds and walls is recommended, since bed bugs tend to reside in these areas during daylight. Enclosing your mattress in plastic, which can be a thrill to sleep on, and coating the legs of the bed with either mineral oil or Vaseline can also be helpful.
The best way to deal with this problem is to avoid it. If you do have to travel, the type of hotel that you choose stay in might be helpful. The problem is here however, and we need to do our best to deal with it. Hopefully, we can limit the problem and contain it in certain areas without transmitting it throughout the country and into our homes.
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