Aspiration culturing of infected wounds seems preferable to surface swabbing because it has been shown to have a 98% concordance rate for aerobes and 92% for anaerobes compared with wound biopsy. Tissue biopsy of infected ulcers is not normally required for clinical decision making. Cultures are obtained to isolate resistive organisms only.

 1.       Thoroughly rinse wound with sterile saline solution prior to culturing.

2.       Do not culture pus or necrotic debris.

3.       Do not culture over hard eschar.

4.       Use non-bacteriostatic saline for aspiration.

5.       Shallow ulcers: Using a TB syringe with needle, spray 1 cc of saline at and under wound edges. Create agitation at the edges with an alginate or rayon swab. Aspirate the solution back into the syringe and inject into appropriate culture media for aerobes and anaerobes.

6.       Deep ulcers: Using a 5 cc syringe with needle extender, inject saline into wound crater. Using an alginate swab, agitate the solution in the crater. Aspirate at least 1 cc of solution back into the syringe and inject into appropriate culture media for aerobes and anaerobes.

7.       All cultured material must reach the lab within two hours in order to obtain accurate results. It is important to obtain a large enough inoculum to detect the causative organism and MRSA.

  

Sources:

1.        Chronic Wound Care, Ed. Diane Krasner, 1990, Health Management Publications, Inc.

2.        Ehrenkranz NJ, Blanca A, Nerenberg, D., Irrigation aspiration for culture draining decubitus ulcers: correlation of bacteriological findings with a clinical inflammatory scoring index; J Clin Microbiol. 1990, 28:2389

3.        Jahniger DW, Infectious Complication of Pressure Ulcers, Geriatric Focus on Infectious Diseases, 1992, Vol. 2, No. 5: 1-3