Stroman Joel C, Reinschmidt Alyssa, Karu Heather
University of South Dakota Sanford School of Medicine.
Department of Surgery, University of South Dakota Sanford School of Medicine.
S D Med. 2025 Apr;78(4):171-175.
Debridement of infected wounds is an essential component of wound healing. Surgical debridement is one option and is typically performed under direct visualization of the wound. It is carried out until healthy tissue is felt to be encountered by the surgeon. Methylene blue has been described as a visual aid in the debridement process, including in the setting of infected prostheses. This study aimed to compare wound healing and device reimplantation times between patients who underwent methylene blue-guided debridement or routine wound care of their infected cardiac device implant pockets. Evaluating differences in rates of recurrent infection following reimplantation was a secondary goal of the study.
Patients were identified for inclusion using a CPT code-based data pull and manual chart review. They were separated into groups dependent upon whether they received routine wound care or methylene blue-guided debridement. Chart review was conducted to estimate the number of days from explantation to wound healing and device reimplantation, and any documentation of reinfection was also recorded. Mann-Whitney U, Student's t, and Chi-square tests were performed using jamovi.
To date, 13 patients have been included in the analysis. Methylene blue-guided debridement is associated with significantly faster time to wound healing (p = 0.011). A significant difference in the interval between explantation and reimplantation was noted, with those in the methylene blue group having shorter intervals (p = 0.036). Differences in reinfection rates were nonsignificant.
Methylene blue-guided debridement appears to significantly improve time to wound healing and time to device reimplantation in patients who have undergone device explantation secondary to infection.
感染伤口的清创术是伤口愈合的重要组成部分。手术清创是一种选择，通常在直视伤口的情况下进行。一直进行到外科医生感觉到遇到健康组织为止。亚甲蓝已被描述为清创过程中的一种视觉辅助工具，包括在感染假体的情况下。本研究旨在比较接受亚甲蓝引导清创术或对其感染的心脏设备植入袋进行常规伤口护理的患者之间的伤口愈合和设备重新植入时间。评估重新植入后反复感染率的差异是该研究的次要目标。
使用基于CPT代码的数据提取和手动病历审查来确定纳入的患者。根据他们是否接受常规伤口护理或亚甲蓝引导清创术将他们分为不同组。进行病历审查以估计从取出到伤口愈合和设备重新植入的天数，并且还记录了任何再感染的记录。使用jamovi进行曼-惠特尼U检验、学生t检验和卡方检验。
迄今为止，已有13名患者纳入分析。亚甲蓝引导清创术与伤口愈合时间显著加快相关（p = 0.011）。注意到取出和重新植入之间的间隔存在显著差异，亚甲蓝组的间隔较短（p = 0.036）。再感染率的差异不显著。
对于因感染而进行设备取出的患者，亚甲蓝引导清创术似乎能显著缩短伤口愈合时间和设备重新植入时间。
