Post-cryotherapy wounds: Non-antiobiotic emulsion, polysporin therapies deemed equally effective

Key Points

Winston-Salem, N.C. - The application of a trolamine-based topical emulsion proves as effective in healing post-cryotherapy wounds as a topical antibiotic-based therapy, according to the results of a study.

Cryotherapy is a common treatment used for actinic keratoses (AK). The ensuing erythema, blistering and crusting that develop at the treatment site are typically treated with topical antibiotic ointments such as polysporin ointment.

However, routine use of topical antibiotic therapy in these clean surgical wounds is becoming a debated issue, especially as antibiotic-resistant bacteria are on an alarming rise.

Brad A. Yentzer, M.D., senior clinical research fellow in the department of dermatology, Wake Forest University School of Medicine, Winston-Salem, N.C., and colleagues conducted an investigator-blinded study in which 20 participants (average 71 years of age) were randomized to apply a trolamine/sodium alginate topical emulsion (Biafine, OrthoNeutrogena) to cryotherapy-inflicted wounds on one forearm, and standard topical wound therapy with polysporin to cryotherapy-inflicted wounds on the other arm.

Participants applied the topical medications three times a day for four weeks to the areas treated with liquid nitrogen at the baseline visit. Target lesions were then assessed for the degree of erythema, thickness, crusting/scabbing and overall severity of each individual lesion at baseline and weeks one, two and four follow-up.

Results

Results showed that the trolamine emulsion was as effective as the polysporin wound therapy. There were no reports of any adverse events throughout the treatment period in either study group, and, importantly, there were no increased wound infections in those who applied the topical trolamine compared to the topical polysporin group. Also, according to Dr. Yentzer, trolamine therapy works up to 2.3 days faster in healing clean surgical wounds compared to standard therapies.

Antibiotic resistance

"Essentially, antibiotics are weapons against microbes which are constantly evolving. The problem is that possibly in the not-too-distant future, we may be running out of drugs that attack these now-resistant bugs.

"It would simply make perfect sense to use another product, such as an organic topical therapy . . . that can do the same job and, in this case, even work faster," Dr. Yentzer tells Dermatology Times.

"Many physicians are already using trolamine for wound healing; however, not nearly as many use polysporin. This may be because of sheer habit or maybe because of the higher price tag that trolamine carries," Dr. Yentzer says.

"The fact of the matter is that trolamine proves to be just as effective in wound healing, and topical antibiotics are simply not always necessary for post-cryotherapy wounds, particularly clean surgical wounds," he adds.

Dr. Yentzer says local antibiotics are over-used in dermatology, and a fundamental shift away from this practice and toward products such as trolamine can be advantageous in curbing the rising antibiotic-resistant strains seen in wound therapy.

Disclosure: Dr. Yentzer reports no relevant financial disclosures.