Mohs surgeons' use of topical emollients in postoperative wound care

Although there is no universally accepted topical emollient recommended for wound care, there has been a trend toward minimizing exposure to common culprits of allergic contact dermatitis.

To assess the current practices of postoperative emollient use of dermatologic surgeons.

An anonymous 10-question survey on postoperative emollient use for clean surgical wounds was e-mailed to 857 members of the American College of Mohs Surgery.

Two hundred ninety-four members (34.3%) responded. After routine closure, the most commonly used topical emollient placed immediately postoperatively was petroleum jelly (53.1%), followed by Aquaphor (Beiersdorf Inc., Wilton, CT) (19.4%) and bacitracin (8.2%) (p < .001). Respondents recommended that patients use the following topical emollients at home to keep the wound moist: petroleum jelly (69.4%), Aquaphor (38.4%), bacitracin (10.0%), mupirocin (9.2%), polymyxin (8.8%), neomycin (2.0%), and gentamicin (1.0%) (p < .001). The three most common topical emollients that were requested not to be used were neomycin (92.8%), polymyxin (44.3%), and bacitracin (44.3%) (p < .001).

Although emollients with low risk for contact allergy such as petroleum jelly are used more frequently, topical antimicrobials with known sensitizing potential are being applied and recommended for clean surgical wounds. A change in practice is needed to avoid these allergens.