A Study On Methylene Blue Guided Surgical Debridement Of Diabetic Foot Ulcers

Background: Effective debridement is of utmost importance for Diabetic Foot Ulcer (DFU) to progress through the stages of wound healing. The removal of devitalized tissues is critical in promoting angiogenesis, vasculogenesis, and the development of granulation tissue, which facilitates healing in an accelerated time frame and prepares the wound bed for additional intervention measures. Methods: A quasi-experimental study of 50 patients with DFU admitted in ward of Department of General Surgery, divided into two Groups A (Methylene Blue dye used) and B (dye not used). Clinical assessment of the ulcers, along with analysis of biochemical, pathology, microbiology reports of these patients were done serially over a course of 6 weeks. Results: In the following study, we observed a demographic distribution where M/F – 7/3, with mean age of males being 56 years and that of females -57 years. 70 % were on OHA and 30 % on Insulin. Most common ulcer sites were sole and dorsum of foot. Majority of the patients had Wagner’s Grade I ulcer, while grade II was seen in 20 % of participants and grade III in 5%. Bacterial isolates predominantly showed pseudomonas. Serial assessment of ulcer size (surface area) shows significant statistical association between reduced progression of ulcer size with use of MB (grp A). Also, the time required for complete elimination of necrotic tissue was less in group A than B, with higher rates of SSG also seen. Conclusion: Precise surgical debridement with the aid of MB helps in more effective removal of necrotic areas with preservation of viable tissue as compared to conventional technique