Use of a Polyvinyl Alcohol Foam Dressing Impregnated with Gentian Violet and Methylene Blue for the Management of Exudate and Bioburden in Patients with Pyoderma Gangrenosum

Pyoderma gangrenosum, identified in 1930, affects approximately 1 person in 100,000; in their 40s and 50s. It is a condition that is often complex with necrosis and high risk of bioburden.  The ulcers usually occur on the legs however an atypical form may occur in other parts of the body. These ulcers often lead to chronic wounds, concerns for bioburden, critical colonization and the risk for infection. The prevalence of pain and scarring are also a major concern. The purpose of this poster was to document the benefits of a bacteriostatic dressing*.and suggest it may be helpful to use a dressing that manages bioburden while absorbing exudate. 

When wounds fail to progress, the challenge begins. There are a number of dressings available for chronic non-infected wounds.  It is beneficial to  select a dressing that is indicated to minimize bioburden, and absorb exudate. This poster describes the use of a bacteriostatic dressing* in a small series of patients with pyoderma gangrenosum.

The three cases represent a variety of wounds due to pyoderma gangrenosum, including peristomal, abdominal and lower extremity. These wounds were not responding to other topical treatments.  In two of the cases an enzymatic agent and in one a topical steroid was used under the bacteriostatic dressing.   

In each case, the wounds healed without complications.  Additional anecdotal observations by the clinicians included the patients reported reduced intensity of pain, necrotic debris was eliminated, and there was no periwound maceration.  Observations at later timeframe revealed there was less scar formation than typically evident with this type of wound.  Infrequent dressing changes were required, which minimized the need for follow up in the wound clinic or for home health nursing visits. The ability to use the bacteriostatic dressing* with topical agents may have been a benefit for these wounds.