A prospective evaluation of methylene blue and gentian violet dressing for management of chronic wounds with local infection

Int Wound J. 2017 Dec;14(6):1029-1035. doi: 10.1111/iwj.12753. Epub 2017 May 16.


The objective of this prospective, non-randomised study was to evaluate the performance of an antibacterial foam dressing containing methylene blue and gentian violet (Hydrofera Blue Classic dressing® ) for the management of chronic wounds with local infection. Patients in this study were ≥18 years of age (n = 29), and each had at least one chronic wound ≥1 cm2 in size that showed signs of localised infection or critical colonisation but with good potential for healing based on clinical assessment. To all of these wounds, the dressing was applied and changed three times per week over the 4-week study period. The primary endpoints of the study were: (i) changes in wound surface area measurement, (ii) changes in Pressure Ulcer Scale for Healing (PUSH) scores, (iii) changes in percent surface area of devitalised tissue (i.e., yellow slough or other necrotic tissue) and (iv) changes in clinical signs associated with localised wound infection/critical colonisation. Participants were evaluated at presentation (week 0 = baseline), week 2 and at week 4 (end of the study). The 29 patients completed the study, and at week 4, the following wound improvements were observed: (i) baseline mean wound surface area was significantly reduced by 42·5%, from 21·4 to 12·3 cm2 at week 4 (P = 0·005); (ii) baseline mean PUSH score decreased significantly from 13·3 to 10·7 at week 4 (P < 0·001); (iii) baseline mean wound coverage by devitalised tissue (%) was significantly reduced, from 52·6 % to 11·4% at week 4 (P < 0·001) and (iv) the mean UPPER and LOWER wound infection scores were reduced from 3·6 at baseline to 0·9 at week 4 (75%; P < 0.001). These results indicate that the Hydrofera Blue Classic dressing was effective at managing these chronic wounds and helped them progress onto a healing trajectory.

Keywords: Desloughing; Gentian violet; Local wound infection; Methylene blue.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Infective Agents, Local / therapeutic use*
  • Bandages*
  • Chronic Disease
  • Female
  • Gentian Violet / therapeutic use*
  • Humans
  • Male
  • Methylene Blue / therapeutic use*
  • Middle Aged
  • Prospective Studies
  • Skin Ulcer / etiology
  • Skin Ulcer / pathology
  • Skin Ulcer / therapy*
  • Treatment Outcome
  • Wound Healing
  • Wound Infection / etiology
  • Wound Infection / pathology
  • Wound Infection / therapy*
  • Young Adult


  • Anti-Infective Agents, Local
  • Gentian Violet
  • Methylene Blue