Bacitracin in wound healing

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Does anyone know what evidence is out there, or what the official guidelines are, for use of bacitracin in the first 24 hours after a simple suture repair? Since medical school, I have heard many surgeons and ER docs with many years of experience with various answers including not in first 24 hours (delays wound healing), immediately after repair and continued indefinitely (promotes wound healing), and only in the first 24 hours (while the wound is epitheliazing). Anyone know what the evidence is, or the "official" word from the text books?

There is an amazing lack of useful research on this subject. Most of the studies that I have seen have either been put togethor poorly or failed to show statistical signifigance. There was a study in the American Journal of EM in 2004 out of Metrohealth that seemed to indicate a lower total rate of infection but alas their results were not statistically signifigant aka. not enough power to the study (under 100 patients). Anyway, I have heard people go either way with it. Possibly a good research study for an enterprising resident?

similar to ^
i looked up this article for a journal club deal. nothing about improved wound healing times, but does indicate fewer infections with neosporin and bacitracin compared to vaseline. again, pretty low powered study

Dire DJ, Coppola M, Dwyer DA, Lorette JL, Karr JL. Prospective evaluation of topical antibiotics for preventing infections in uncomplicated soft-tissue wounds repaired in the ED. Acad Emerg Med 1995; 2:4-10.

While in derm clinic I remember the attending saying that many people will actually develop an allergy to bacitracin -- making me think that it will have little if not deleterious effects in a wound with a low likelihood of infxn in the 1st place.

---but what do I know?