Managing challenging, non-healing wounds using a dressing containing methylene blue and gentian violet

Chronic non-healing wounds are a significant challenge for patients and healthcare providers and significant cost to the healthcare system in Canada.¹ Superficial or local infection is one major cause of delayed wound healing and topical antibacterial/antimicrobial dressings may be used to address this increased wound bioburden.^2,3 Three case studies will be presented to illustrate challenging non-healing wounds that were managed in out-patient settings in Western Canada using an antibacterial dressing containing methylene blue and gentian violet (MBGV).

Case 1: 80 year-old male with hypertension, anemia and chronic heart failure. Developed a wound post-surgical intervention which did not decrease in size for 11 months.  Wound size prior to management with the MBGV dressing was 1.3 x 0.8 x 0.7 cm. Result:  Complete closure occurred at 4 weeks.

Case 2: 93 year-old male with a history of hypertension and gout. Sustained traumatic wound to left lower leg which did not progress for 7 months. Ankle brachial index of the limb was 0.93. Wound size prior to management with the MBGV dressing was 4.0 x 3.5 cm with hypergranulation present. Result:  Complete closure occurred at 8 weeks.

Case 3: 91 year-old male with a right shin traumatic wound who underwent 2 skin grafts that failed. A subsequent diagnosis of pyoderma gangrenosum was made and the wound did not progress for 5 months. Wound size prior to management with the MBGV dressing was 16 x 13 cm. Result:  In 11 weeks, the wound size decreased to 4.0 x 1.0 cm.

Conclusions: The MBGV dressing may have contributed to complete healing in cases 1 and 2. For case 3, the percentage reduction in wound size over 11 weeks was 98%.