Wound Care Ointment Ingredients

At present, the core functional ingredients of domestically compliant medical and mechanical wound care ointments can basically be classified into three categories: wound repair, antibacterial protection, and moisturizing and sealing. There is no universal optimal formula, and the combination of all ingredients is designed around the wound type and healing stage.

In the past two years, I helped in the surgical dressing room of a community hospital for more than half of the year. I saw too many people buying ointments blindly based on the ingredient list, spending a lot of money, and the wounds got worse. Last month, a sophomore boy broke his knee while riding a shared bicycle. He wiped out a large exudate wound. He bought an "imported repair cream" worth more than 100 yuan through a short video. After applying it for three days, pus leaked. When he brought it to me, I found that the first few ingredients on the list were propolis, The fragrance, and less than 1% asiaticoside, are completely inappropriate - for fresh wounds with exudation, the first priority is antibacterial and anti-infection. The product he chose does not even have basic antibacterial ingredients. Propolis can also easily irritate damaged skin, so it would be strange if it does not aggravate it.

To be honest, I used to think that the more expensive ones were definitely better. It wasn’t until I encountered several cases where the imported ointment costing two to three hundred yuan was not as effective as the Vaseline that cost a few yuan that I really believed that the ingredients were wrong and no matter how expensive it was, it would be useless. For example, the most basic occlusive moisturizing ingredients such as petroleum jelly, lanolin, and mineral oil, although cheap, are really versatile bases. Many high-end ointments are also inseparable from them. Their good occlusive properties can reduce the evaporation of water in the wound and provide a moist healing environment for the wound, which can heal more than twice as fast as in a dry state. But this is not a panacea. Don’t directly apply a thick layer of Vaseline to a wound that exudes a lot. You must first absorb the exudate and use an absorbent dressing to absorb it before applying it. Otherwise, it will become stuffy. I have seen several patients with worn-out feet who smeared a thick layer of Vaseline while wearing sports shoes. After a day, the wound turned white and healed slowly. There is also lanolin, which is particularly friendly to sensitive skin, but about 3% of people are allergic to lanolin. Before using it, it is best to test it on the intact skin behind the ears for 12 hours. If there is no reaction, apply it to the wound.

Nowadays, there are quite big differences in the industry regarding antibacterial ingredients. The old head nurse in our dressing room especially likes to use ointment containing nanosilver for patients with pressure sores and deep second-degree burns. It has a broad antibacterial spectrum and is effective against common drug-resistant bacteria such as methicillin-resistant Staphylococcus aureus. There are also very few allergies. Many patients have their infections under control within three or four days. ； But last time I attended a dermatology academic conference, a professor pointed out that long-term use of silver ions (more than 2 weeks) may destroy the local microecology of the wound and even risk a very small amount of silver deposition. It is also recommended that milder povidone-iodine and chlorhexidine ingredients are enough for superficial wounds. There is no need to use silver ions immediately. Both statements are actually reasonable. The core depends on the risk of infection of the wound. If it is just a small scratch caused by a fall, it is not necessary to use silver ions. If there are signs of suppuration, or it is a pressure ulcer of a bedridden elderly person, the short-term benefit of using silver ions is obviously higher. Oh, by the way, I want to mention that ointments containing chlorhexidine cannot be used together with iodophors and soap. Previously, an aunt changed the dressing at home and applied iodophors first and then chlorhexidine ointment. As a result, a red rash appeared around the wound, which was caused by the reaction of the two ingredients.

As for the repairing ingredients that everyone is most concerned about, such as recombinant human epidermal growth factor, sodium hyaluronate with different molecular weights, and high-concentration asiaticoside, they are indeed useful, but don’t be mythical. For example, for moles and small wounds after minimally invasive cosmetic surgery, using a product containing small-molecule sodium hyaluronate and epidermal growth factor can shorten the healing time and reduce the probability of scarring. However, if the wound is already scabbed and applied again, it is basically useless and may cause pus to accumulate under the scab. There is also the hotly-hyped asiaticoside, which requires a concentration of 2% or above to have a clear healing effect. Many cosmetic brand repair creams add 0.5% to promote healing of light scars. In fact, it is more of a psychological comfort. By the way, there is also the recently popular chitosan ingredient, which is multi-functional. It can not only be antibacterial, absorb exudate, but also promote repair. It is added to many new medical dressings, but the price is a little higher. If you have enough budget, it is also very convenient to use on superficial wounds without the need to apply multiple layers.

One thing to note, don’t be blind to the “pure plant” and “no additives” concepts promoted by merchants. Aloe vera repair ointment and comfrey ointment are fine if they are not broken by mosquito bites or eczema. Don’t use them blindly on wounds that are really broken. Firstly, many of these products are cosmetic brands and cannot meet the sterilization standards. Secondly, the allergenicity rate of plant ingredients is much higher than that of medicinal ingredients. Wounds that do not leave scars in the first place will easily leave marks when allergic and inflamed.

In fact, when choosing a wound care ointment, you really don’t have to look at the ingredient list. For ordinary superficial scratches, ten yuan of povidone-iodine-petroleum jelly ointment is enough. If it is a special area (such as the face) or a deep wound with a high risk of infection, it is much more reliable to ask a doctor directly than to blindly buy it from an internet celebrity.