Ingredients of wound care ointment

The basic matrix is responsible for carrying all ingredients, locking moisture and sealing, active functional ingredients for hemostasis, promoting healing, and anti-infection, as well as auxiliary regulators to maintain the stability of the ingredients and adapt to the wound microenvironment. The differences between ointments at different price points and different applicable scenarios are almost all concentrated in the selection of active ingredients.

A while ago, Aunt Zhang downstairs was spilled by oil when she was cooking. She was squatting in the drugstore and was confused by the ingredients list of a row of burn ointments. She asked me why some said Vaseline, some said silver sulfadiazine, and some said growth factors. Are the more expensive ingredients better? In fact, this is not the case. The adaptation scenarios for different ingredients are far different, and even the industry has not yet reached a completely unified conclusion on the use of many ingredients.

Let’s first talk about the antibacterial ingredients that everyone is most concerned about. Currently, there has been a fierce debate in the industry about whether to add antibacterial ingredients to ordinary daily wounds. One group is a doctor with a clinical background in surgery. They feel that antibacterial ingredients such as silver sulfadiazine and povidone iodine, which are originally used for moderate to severe burns and scalds and postoperative wounds, can reduce the probability of infection when used in daily foot grinding and minor abrasions. However, long-term abuse may increase the skin's drug resistance. Antibacterial ingredients are not effective when serious wounds are encountered. The other group is engaged in the research and development of daily chemical care lines. On the contrary, they believe that most daily wounds are caused outdoors or at home, and the probability of contamination is high. The benefits of adding antibacterial ingredients in low doses far outweigh the risks. It is better than taking antibiotics if the wound is infected. I scraped my knee last time when I was riding a shared bicycle. I used an ointment with sulfonamides at first, and there was indeed no inflammation. But then I switched to a chitosan ointment that does not contain antibacterial ingredients. After the scabs fell off, the pigmentation became lighter. I can’t say who is right and who is wrong. It depends on the condition of the wound.

Many people only look at the active ingredients when choosing an ointment, and ignore the basic base, which accounts for the highest proportion. In fact, this is the key to determining whether it is suitable for you to use. The most common ones are oil-based bases such as petroleum jelly and lanolin, which have strong sealing properties and a water-locking effect. They can be used in winter when the hands and feet are chapped, or the lips are chapped. Applying them will soften them overnight. However, if you use them on scratches that have just been dropped and are still leaking tissue fluid, it will be a trap. Nowadays, many new ointments use water-based bases such as hydrogel and sodium carboxymethyl cellulose. They have good water absorption and can absorb exudate. They are not sticky to the wound and will not tear the newly grown flesh when it is removed. However, the moisturizing time is short and must be applied frequently.

As for the repairing ingredients that are now being touted by businesses, the preferences of practitioners in different fields are quite different. Colleagues in the medical aesthetic field especially like to prescribe ointments containing recombinant human epidermal growth factor to clients who have undergone fractional therapy and microneedling. They say that the ointment can double the speed of wound healing and reduce the probability of leaving discoloration. However, I asked Dr. Li, the surgeon at our community hospital, and he did not recommend using growth factors for ordinary wounds. He said that if you do not wipe away the dust and dirt in the wound, the growth factors will cause the excessive growth of granulation tissue, which will easily lead to bulges and scars. Relatively mild repairing ingredients such as chitosan and madecassoside are recognized by both parties. They can not only fight inflammation and promote healing, but are also less prone to breakouts, so they can be used by sensitive skin with peace of mind.

Many people frown when they see ethyl hydroxyphenyl ester and citric acid in the ingredient list, thinking they are "harmful additives" and are really unnecessary. I once had a friend who likes to do handmade skin care. He made a wound care ointment at home that was claimed to be "additive-free". No preservatives or pH adjusters were added. After a week of wearing new shoes, he rubbed his feet, took them out and applied them. As a result, his feet were so swollen the next day that he couldn't wear shoes. He went to the hospital to find out that the infection was caused by bacteria growing in the ointment. The content of preservatives added to regular ointments is below the safety line required by the country. This is mainly to prevent bacteria from growing after you use it twice, which will be bad for the wound. The pH adjuster is even more important. Adjust the pH of the ointment to a weak acidity close to the skin, so as not to irritate the newly grown delicate tissues.

Oh, by the way, there are also some niche ointments that add "cross-border ingredients" such as medical-grade Manuka honey, which is not only a moisturizing base, but also has anti-bacterial and anti-inflammatory effects. It also has a light honey smell, which is especially suitable for children. It will not turn yellow like iodophor, which will be objectionable to children. In short, you don’t need to look at the more complicated and expensive ingredients list to buy, just choose according to your wound condition. Choose oil-based for small cracks, water-based for bruises with oozing, and choose antibacterial ingredients for severely contaminated wounds. It is better than anything else.