Clinical Case Series: Managing Post-Surgical Wounds Using Methylene Blue and Crystal Violet (MBCV)1 Dressings

 Problem:  Three patients with non-healing post-surgical wounds were admitted to long term acute care hospital (LTACH) for care.

 Past Management:  Patient A admitted 11/15 with anterior-lateral thigh wound status-post debridement following trauma.  Wound was managed with negative pressure wound therapy (NPWT)² prior to admission continuing through 2/9 of the following year.

 Patient B admitted 6/15 following amputation of fingers.  His left hand wound was managed with NPWT prior to admission and through 6/22.

 Patient C admitted 8/19 with left lower extremity fasciotomy wound.  The wound was managed with silver dressings³ prior to admission.

 Current Approach:   Patient A’s wound was hypergranular so NPWT was discontinued and MBCV dressings initiated 2/9.  Electrical stimulation was started on 2/27.  Patient B had MBCV dressings initiated 6/22 to manage exudate, decrease bacterial load and frequency of dressing changes.  Patient C’s wound was converted to MBCV dressings on admission.

 Patient Outcomes:  In 28 days, Patient A’s wound had 32% decreased wound area and 93.2% decreased wound volume.  Dressing change frequency and exudates also decreased.

 In 14 days, Patient B had 10% decreased wound area and 10% decreased wound volume decrease to his wound.  There was also granulation tissue over bone.  There was improvement in reduction of visible biofilm sheen, decrease in hypergranulation tissue, decreased pain, decreased dressing change frequency and increased mobility. 

Within four days, Patient C’s wound had improved granulation tissue.  Patient C had 28.3% wound volume decrease in one week.  In 32 days, Patient C experienced 27.7% decreased wound area and 98.6% decreased wound volume.

 All patients were discharged home.  Patient A’s and Patient B’s wounds epithelialized without further surgical intervention.  Patient C was lost to follow-up.

 Conclusion:  MBCV dressings can promote healing of complex surgical wounds.

¹Hydrofera Blue®, Healthpoint®

²Wound VAC®, KCI®

³Silvasorb Gel®, Medline Industries, Inc.; Aquacel Ag®, ConvaTec USA