Optimizing the wound bed by removing devitalized tissue and managing moisture using methylene blue and gentian violet (MBGV) antibacterial foam dressings: A case series

Aim: Debridement is essential to wound bed preparation, making it a priority intervention in the management of acute and chronic wounds.¹ Maintaining moisture balance is essential for wound healing². Selecting a dressing that helps address patient centered concerns such as pain and exudate  may optimize the patient-clinician collaboration.³ The purpose of this case series is to evaluate the impact of a methylene blue and gentian violet (MBGV) antibacterial foam dressing on devitalized tissue and moisture balance on 3 chronic and 3 acute wounds.

Method: All wounds (surgical excisions, a neuropathic foot ulcer, abdominal and two pressure injury) were managed with the MBGV dressing. The dressing was changed every 2-3 days. For the abdominal wound, the dressing was used to remove devitalized tissue prior to negative pressure wound therapy (NPWT). Additional therapies (e.g. pressure redistribution, compression) were used when indicated to address the underlying cause. Digital images and wound measurements were taken to assess for condition of periwound skin and changes in wound size and amount of devitalized tissue.

Results:  Five of the six wounds reduced in size and exhibited a decrease in percentage of devitalized tissue during the use of the dressing.  One of the surgical wounds exhibited a reduction of devitalized tissue from 95% to 50% of the wound surface area in 2 days, allowing NPWT to be initiated. The periwound skin remained intact in all cases. Use of the MBGV dressing, in two 90 year old individuals, supported removal of devitalized tissue and enhanced granulation tissue, improvement to pain management where previously they had been unable to tolerate NPWT.

Implications: Results of this case series (removal of devitalized tissue and optimizing moisture balance) indicate the MBGV dressing is a suitable choice for acute and chronic wounds with devitalized tissue and varying levels of wound exudate.