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Is wound swabbing evidence based?

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12 July, 2011

It’s the most common sampling method in the UK, but does it have clinical value? Does moistening the swab increase bacteria survival in the wound? Is routine swabbing helpful?

Readers' comments (5)

  • good topic - v. interested to hear what people say about this

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  • I think we do it and don't question why we do it routinely

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  • Good question and, as a student has made me think. Agree with other reader, that it is something nurses do and dont question. Surely, though wound swabbing, (apart from screeening), is normally undertaken when wound shows some sign of infection?

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  • Richard White

    This, together with many other wound infection-related issues, is of fundamental importance to best practice. I strongly recommend that all clinicians who regularly (or even only occasionally) encounter wounds, to make themselves aware of the current best practice for the topical management of wounds with antimicrobials. It is freely available from the Wounds-UK website:
    http://www.wounds-uk.com/pdf/content_9969.pdf

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  • Andrew Kingsley

    The key point is that wound infection is a clinical diagnosis not a microbiological one. The swab result is a check method to see if correct antibiotics have been given based on the antibiotic sensitivities of the pathogens identified. Screening swabs may also identify MRSA or another ARO (Antibiotic Resistant Organism) which depending on local policy may need to be treated if identified. Excepting the occasions when you are mandated to undertake a screening swab I agree with Debra S that you only take a swab when there are clinical signs of infection. There is much debate on how to take a swab with the common zigzag probably the most used though I am beginning to veer towards the Levine technique and am considering the value of its introduction to my organisation. Microbiology is as much an art as a science because the results require interpretation. Currently the understanding is beginning to shift from the single pathogen as cause of infection to the collective bioburden working as a whole to create infection but in current normal clinical practice settings in the UK we are still taking the traditional approach. Critically colonised wounds need debridement and topical antimicrobials/antiseptics and do not normally need swabbing.

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