gentian violet – a blessing in disguise for the developing world
TRANSCRIPT
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ifference between the cohorts. This suggests that patients
ttending our burns centre now suffer from twice the burden
f co-morbidity. Closer investigation of co-morbidities showed
n even increase in concurrent psychiatric co-morbidities in
he 2012 cohort (11.5% in 2002 and 17.2% in 2012).
In 2002, 3.1% of patients suffered from burns secondary to
heir other illnesses, with 31.2% of patients acquiring injuries
t work. On the other hand in 2012, 11.6% of patients sustained
urns as due to co-morbid conditions and 9.3% sustained
njuries at work, suggesting a shift in burn causes over the
ecade. Another difference between cohorts concerns depth
Letter to the Editor
Gentian violet – A blessing in disguise for thedeveloping world
Crystal violet or Gentian violet is a triarylmethane dye used as
a histological stain and in Gram’s method of classifying
bacteria. Crystal violet has antibacterial, antifungal, and
antihelmintic properties and was formerly important as a
topical antiseptic. It is used topically in various mouth ulcers,
b u r n s 3 9 ( 2 0 1 3 ) 1 3 2 1 – 1 3 2 7326
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Conflict of interest
f burn and TBSA. In 2002, the mean TBSA was 4.7%, compared
o 2.4% in 2012 ( p = 0.0144). In addition, a higher percentage of
ull thickness burns were seen in 2002 (37.5% full thickness vs
3.5% partial thickness), compared to the 2012 cohort (15.1%
ull thickness vs 57.0% partial thickness). This suggests that
atients are currently admitted to the burns centre with less
evere burns than a decade ago. Interestingly there was no
tatistical difference in the mean age of patients between 2002
nd 2012 (46.1 and 45.9 respectively).
Our study suggests that over the decade there has been an
ncrease in co-morbidities of patients presenting at our burns
entre, which brings challenges to burns care. With burns care
ow multi-disciplinary in approach, it is important to make
ure that appropriate support is sought from medical teams
nd other multi-disciplinary team members to ensure optimal
anagement of patients medical co-morbidities in order to
aximise potential outcomes following burns. Although a
evere burn is often the most pressing issue in these patients,
hanges in the burn population demonstrate how a holistic
pproach should be appreciated.
e f e r e n c e s
1] Ryan CM, Schoenfield DA, Thorpe WP, Sheriden RL, CassemEH, Tompkins RG. Objective estimates of the probability ofdeath from burn injuries. N Engl J Med 1998;338:362–6.
2] Palmu R, Isometsa E, Suominen K, Vuola J, Leppavuori A,Lonnqvist J. Self-inflicted burns: an eight year retrospectivestudy in Finland. Burns 2004;30:443–7.
Lyudmila Kishikova*
Samuel Odeyinde
Baljit Dheansa
Queen Victoria Hospital NHS Foundation Trust, Holtye Road, East
Grinstead, West Sussex, RH19 3DZ, United Kingdom
Corresponding author at: Brighton and Sussex Medical School,
SMS Teaching Building, University of Sussex, Brighton, East
Sussex, BN1 9PX, United Kingdom.
Tel.: +44 7929177442
E-mail address: [email protected] (L. Kishikova)
0305-4179/$36.00
# 2013 Elsevier Ltd and ISBI. All rights reserved.
http://dx.doi.org/10.1016/j.burns.2013.03.001
T
brasions and superficial skin infections. In aqueous solutions
t dissociates into positive and negative ions that penetrate
hrough the wall and membrane of both Gram-positive and
ram-negative bacterial cells. Evidence also suggests that
entian violet dissipates the bacterial (and mitochondrial)
embrane potential by inducing permeability. This is fol-
owed by respiratory inhibition. This anti-mitochondrial
ctivity might explain gentian violet’s efficacy towards both
acteria and yeast with relatively mild effects on mammalian
ells [1,2].
Throughout the world, burns remain a huge health issue,
nd especially in developing countries due to its high cost of
reatment and management which results in increase
orbidity or mortality in severe cases [3]. Burn wounds are
terile immediately after being inflicted but are liable to be
olonized very rapidly by bacteria. Gentian violet being an
ntibacterial agent can be used to fight against bacterial
nfections in these cases. According to study of Harvard
edical School in which various agents are being assessed for
urns treatment, a two per cent solution of gentian violet, was
prayed on to the area, the dye stopped the bleeding from the
urface quickly and the eschar formed more rapidly as
ompared with other agents [4]. Another study in June 2000
hows the efficacy of gentian violet in healing wounds. The
ye does not only decrease the wound size but reduces pain as
ell, which suggest that it has a mild analgesic effect too [5]. A
tudy conducted in Philadelphia also suggest gentian violet to
e an effective agent for curing burn wounds, following results
re obtained when it is used in 1st and 2nd degree burns in
ombination with an antibiotic [6].
To date no case of acute gentian toxicity has been reported
n external use. However, there are evidence that it may cause
astrointestinal tract irritation on oral use, decrease white
lood cell count on IV and some evidence suggesting a
arcinogenic effect of triphenylmethane-classed dyes of
hich gentian violet is a member but in rodents not human
eings [7].
In view of mentioned studies, gentian violet has proved to
e an efficient agent for reducing bacterial growth as well as in
ealing wounds with mild analgesic effect. Thus, this cost
ffective agent’s use as a first aid agent in burns, though needs
o be further investigated; but once proven useful can be
eneficial especially in developing countries that have limited
esources and budgets allocated for health care.
he authors have no conflicts of interest or funding to disclose.
b u r n s 3 9 ( 2 0 1 3 ) 1 3 2 1 – 1 3 2 7 1327
r e f e r e n c e s
[1] Adams E. The antibacterial action of crystal violet. J PharmPharmacol 1967;19(December (12)):821–6.
[2] Tolba MK, Saleh AM. Studies on the mechanism of fungicidalaction of crystal violet on mycelial felts of Fusarium culmorum.Arch Mikrobiol 1963;47(December (2)):201–6.
[3] Ogundipe KO, Adigun IA, Solagberu BA. Economic burden ofdrug use in patients with acute burns: experience in adeveloping country. J Trop Med 2009;2009 (article ID 734712, 4pages).
[4] Cannon B, Cope O. Rate of epithelial regeneration: a clinicalmethod of measurement, and the effect of various agentsrecommended in the treatment of burns. Ann Surg1943;117(January (1)):85–92. PMCID: PMC1617469 (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1617469/).
[5] Mak SS, Molassiotis A, Wan WM, Lee IY, Chan E.S.. TheEffects of hydrocolloid dressing and gentian violet onradiation-induced moist desquamation wound healing.Cancer Nurs 2000;23(June (3)):220–9.
[6] Thompson CW. Topical application of penicillin: solution,gentian-violet and heat in the treatment of extensive 1st and2nd degree burns in children. J Natl Med Assoc1946;38(January (1)):11–4. PMCID: PMC2616807 (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2616807/).
[7] Docampo R, Moreno SN. The metabolism and mode of actionof gentian violet. Drug Metab Rev 1990;22(2–3):161–78.
Syed Arsalan Ali*,1
House # B-202, Habib Complex, Block L,
North Nazimabad,
Karachi, Pakistan
Gulrayz Ahmed1
D-31, Block 8, Gulshan e Iqbal, Karachi, Pakistan
Shaikh Hamiz-ul-Fawwad1
House # R-27, Sector 15 A-4, Bufferzone,
Karachi, Pakistan
Syeda Aimen Waqar1
A-480 Block ‘‘J’’ North Nazimabad, Karachi, Pakistan
Anum Saleem1
16-E Rainbow Appartments Block ‘‘M’’ North Nazimabad,
Karachi, Pakistan
*Corresponding author. Tel.: +92 3332378207;
fax: +92 2134265421
E-mail address: [email protected] (S. Arsalan Ali)
[email protected](G. Ahmed)
[email protected](S. Hamiz-ul-Fawwad)
[email protected](S.A. Waqar)
[email protected](A. Saleem)
14th Year MBBS Students, Dow Medical College,
Dow University of Health Sciences, Karachi,
Pakistan.
0305-4179/$36.00
# 2013 Elsevier Ltd and ISBI. All rights reserved.
http://dx.doi.org/10.1016/j.burns.2013.02.004