Hi everybody. What has been your experience regarding obtaining swab cultures from traumatic wounds done initially in the emergency dept? are they worth it?
Usually you should try to get the secretion aseptically, so swabs may not be the first option. Furthermore, you could lose a considerable part of the sample, thus swab should only be done when you have a lot of secretion. This paper may be helpful.
Wound swabs from traumatic wounds are a waste of time as they are not representative of the organisms that end up causing infection. In addition the infective potential from clean traumatic wounds is overestimated. If you need microbiological assessment if a wound you need tissue samples or pus, not swabs.
It is possible to obtain wound swabs from traumatized wound but need a lot of caution to avoid contamination. Some of the organisms might be present as opportunistic pathogens and there is need for transport medium. Please find the attached it may be useful. Thanks
Article Antibiotic Resistance Profile of Staphylococci Isolated From...
We avoid swabs for culture as much as possible as you will not know what you are dealing with either commensals or pathogens. Hence, it is advised that one takes tissue samples,or bone curettage or any aspirates from the site but not swabs.
Wound/ bone aspirate or curettage, avoid swabs in all tissue injuries. Smear and culture, ask for a description of the flora, leukocytes and their aspects: in or extracellular, then you will know what you are dealing with: contaminants or pathogens. Never forget to refer to fungi, especially in old fractures and to acid fast bacilli.