Cohen Children's Medical Center, Great Neck, New York.
Wounds. 2021 Oct;33(10):253-259.
Topical antimicrobial treatment of wounds in pediatric, and especially neonatal, patients can be challenging due to increased systemic absorption, damaging inflammatory cytokines, and oxygen radicals released by bacterial death. A product combining all wound bed preparation principles is desired. Methylene blue and gentian violet (MB/GV) foam dressings can keep wound beds moist, decrease ongoing inflammation, provide antibacterial coverage, and promote healthy wound edges.
This article examines the use of MB/GV antibacterial foams in pediatric patients. Cases included infants with giant omphalocele epidermal stripping, dehisced abdominal wounds, peristomal dermatitis, and peripheral intravenous extravasations and adolescents with stage 4 pressure injuries. The treatment goals were to optimize the wound bed through debridement, elimination of bioburden, providing moisture balance, and enhancement of granulation tissue growth.
Eight patients (6 infants and 2 adolescents) received MB/GV foam dressings every 2 to 3 days along with standard of care (SOC) management.
Effective debridement, bioburden elimination, moisture balance, and edge enhancement were achieved in all wounds. All wound beds were well-prepared to receive other SOC products as needed. Three cases were considered for negative pressure wound therapy (NPWT), but NPWT was not used because of challenging clinical characteristics and wound locations. Instead, MB/GV polyvinyl alcohol foam provided capillary wicking action that enhanced wound closure without NPWT. No side effects were observed.
Methylene blue and gentian violet foam dressings appear to be a safe clinical option for antibacterial coverage, moisture management, and debridement in neonatal and pediatric patients.
由于新生儿和儿童患者的全身吸收增加、破坏炎症细胞因子和细菌死亡释放的氧自由基，因此，对儿科，尤其是新生儿患者的伤口进行局部抗菌治疗具有一定挑战性。人们希望有一种产品能够结合所有伤口床准备原则。亚甲蓝和龙胆紫（MB/GV）泡沫敷料可以保持伤口床湿润，减少持续的炎症，提供抗菌覆盖，并促进健康的伤口边缘。
本文研究了 MB/GV 抗菌泡沫在儿科患者中的应用。纳入的病例包括患有巨大脐膨出表皮剥脱、裂开的腹部伤口、肛周皮炎和外周静脉输液外渗以及患有 4 期压力性损伤的青少年患者。治疗目标是通过清创、消除生物负荷、保持水分平衡和促进肉芽组织生长来优化伤口床。
8 名患者（6 名婴儿和 2 名青少年）每隔 2-3 天接受 MB/GV 泡沫敷料和标准护理（SOC）管理。
所有伤口均实现了有效的清创、生物负荷消除、水分平衡和边缘增强。所有伤口床都已准备好根据需要接受其他 SOC 产品。有 3 例考虑使用负压伤口治疗（NPWT），但由于具有挑战性的临床特征和伤口位置，未使用 NPWT，而是使用 MB/GV 聚乙烯醇泡沫提供毛细血管虹吸作用，无需 NPWT 即可促进伤口闭合。未观察到副作用。
亚甲蓝和龙胆紫泡沫敷料似乎是一种安全的临床选择，可用于新生儿和儿科患者的抗菌覆盖、水分管理和清创。
