Case Series: Optimizing wound healing in challenging lower extremity wounds using a Gentian Violet/ Methylene Blue Wide-Cell Polyvinyl Alcohol antibacterial foam in conjunction with traditional Negative Pressure Wound Therapy

Chronic lower extremity wounds can result from a myriad of different diseases. Many of wounds do to size and severity respond well to NPWT. A common issue is that different tissues require different interfaces. Polyvinyl alcohol (white foam) for bone and tendon. Polyurethane (black foam) for muscle and granulation tissue.

This can generate very complex dressing applications. If there are errors in the application process poor outcomes can occur. This is a common problem with varying skill sets of the caregivers applying NPWT. The new Gentian Violet/ Methylene Blue (GV/MB) Wide-Cell Polyvinyl Alcohol (PVA) antibacterial foam can be applied across all tissue structures. This reduces the chances of application errors.

There were other benefits as well. We utilized the single layer of Gentian Violet/ Methylene Blue (GV/MB) Wide-Cell Polyvinyl Alcohol (PVA) antibacterial foam applied directly to the wound bed with NPWT on deep, complex wounds, with varying tissue structures exposed. We commonly covered bone, tendon, fascia, muscle, and granulation tissue. Dressing changes were typically two times a week or three if necessary. The wound beds were consistently cleaner, increased granulation tissue over exposed bone and tendon, and decreased odor, minimal tissue to no foam retention in the granulation tissue from the wound during dressing changes, and very aggressive tissue ingrowth/ depth reduction.

The combination of the GV/MB wide cell PVA anti-bacterial foam and traditional NPWT offered a solution to heal chronic lower extremity wounds that would be high risk of infection. The clinical outcomes showed a decrease in wound surface area over a period of 2-4 weeks. None of the patients’ wounds became infected. Two patients had wound complications.

We utilized the combination of the GV/MB wide-cell PVA antibacterial foam and NPWT to aggressively progress wounds from deep to superficial wounds ready to accept CTP or other modality of achieving final closure.