WOUND, CULTURE, DEEP (E.G., HUMAN BITE/ANIMAL BITE), AEROBIC/ANAEROBIC BACTERIA,

Test Code: WS, TIS, FLU, TIAN, FLAN, WAN

Test Indications:
Suspected open wound infection. Wound infections should be suspected when an area of skin around a wound demonstrates increased discharge (often purulent), increased erythema, increased pain or swelling. Wound cultures should not be performed on patients without clinical infection. For closed abscesses, see "Tissue (Biopsy)/Tissue Aspirate/Bone, Culture, Aerobic/Anaerobic Bacteria", for burn tissue cultures, see "Burn Tissue/Exudate, Culture, Aerobic Bacteria".

Recommendations:
Wound swabs should only be performed in patients with uncomplicated skin and soft-tissue infections associated with a wound where typical pathogens are anticipated. For complicated wounds (diabetic foot infections, osteomyelitis, complicated post-surgical wounds, necrotizing wounds, atypical pathogens, chronic wound infections, etc.), or cellulitis without an open wound, aspirates or tissue biopsies are the preferred diagnostic specimen. Wound swabs are not suitable for anaerobic culture. If anaerobes are suspected, obtain aspirates or tissue biopsies.  If a wound swab is submitted for anaerobic culture, ordering practitioners must specifically indicate that they are from infections where anaerobic bacteria may play a role (e.g., deep abscess, ulcerated lesions, necrotic lesions, soil-contaminated wounds, etc.) for the culture to be processed. Prior to the collection of any specimen, remove all exudate, purulent material and necrotic tissue from the wound. Wash the wound thoroughly using normal saline. Wound base should be visible and free of exudate, pus and necrotic tissue before sampling. Specimens should be taken before antibiotic treatment. If a swab is used, wash the wound as above and place the wound swab on the base of the wound. With firm pressure, rub the swab on the wound bed in a zig-zag pattern. Place the swab in the transport tube and request aerobic cultures. NEVER SUBMIT TISSUES OR ASPIRATES IN SWAB TRANSPORT MEDIA. NEVER SUBMIT ASPIRATES IN SYNRINGES. For suspected fungal infections (e.g., aspergillosis, blastomycosis) always submit aspirates or tissues and request fungal culture. For suspected chronic mycobacterial infections, submit tissue and order mycobacterial culture (AFB culture). 

Patient Preparation Instructions:
Accurate patient identification must be made prior to sample collection.
Samples and requisitions must be labeled/completed in accordance with the Shared Health Specimen Acceptance Policy. Prepare wound bed as described in recommendations above.

Specimens received in non-sterile containers (aspirates and tissues) or other collection devices will not be processed.

_SH Microbiology - Provincial Requisition (R250-10-06)

A descriptive report will be provided.

Daily

TISSUE BIOPSY/TISSUE ASPIRATE/ABSCESS/ASPIRATE FLUID/BONE, CULTURE, AEROBIC/ANAEROBIC BACTERIA

BURN TISSUE/EXUDATE, CULTURE, AEROBIC BACTERIA

WOUND, CULTURE, SUPERFICIAL (E.G., DECUBITUS ULCER/ ABSCESS/IMPETIGO), AEROBIC BACTERIA

Specimen Handling:
Specimens should be received by the laboratory within 24 hours. Store at room temperature.  Ensure specimens are sent using appropriate packaging in accordance with Transportation of Dangerous Goods Regulation.