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Increased bacterial burden has been identified as a key factor contributing to delayed wound healing and other serious complications (1). The purpose of this case series is to evaluate a dressing containing Methylene Blue and Gentian Violet (MBGV) for the management of chronic wounds that exhibit clinical signs associated with increased bacterial burden.
Method:
29 participants between 18-85 years of age with a chronic wound of various etiologies (pressure ulcers, diabetic foot ulcers and surgical wounds) enrolled in the study. Their wounds were evaluated weekly for four weeks to determine changes in wound surface area, exudate level, and wound tissue type using the Pressure Ulcer Scale for Healing (PUSH tool) (2). Wound infection was evaluated by the Clinical Signs and Symptoms Checklist (3) that included the following assessment parameters: pain, erythema, edema, heat, purulent exudate, drainage, color, friable granulation tissue, odor, and wound breakdown.
Results:
Twenty-nine participants completed the study. At baseline, all wounds were documented to have moderate to heavy exudate, foul odor and devitalized tissue present in the wound bed. The mean PUSH score was 13.27 (SD= 2.15) and mean infection score was 3.55 (SD=1.09). At the end of week four, all wounds achieved a granulating wound bed with a mean PUSH score of 10.69 (SD=2.25) and mean infection score of 0.86 (SD=0.92). There was a significant improvement in odor and reduction of devitalized tissue (p<0.001), and in the mean wound size from 21.4 cm2 (SD=27.6) at baseline to 12.32 cm2 (SD=18.74) at week four according to paired t-test (t=3.07, df=28, p<0.005). None of the participants required antibiotic treatment for wound infection during the study.
Conclusion
Results of this study indicate that the dressing is a suitable option for chronic wounds exhibiting signs of increased bacterial burden as part of an overall wound management plan.