Title

Diagnostic validity of three swab techniques for identifying chronic wound infection

Document Type

Article

Peer Reviewed

1

Publication Date

1-1-2006

Journal, Book or Conference Title

Wound Repair and Regeneration

NLM Title Abbreviation

Wound Repair Regen

PubMed ID

17014666

DOI

10.1111/j.1743-6109.2006.00162.x

Abstract

This study examined the diagnostic validity of three different swab techniques in identifying chronic wound infection. Concurrent swab specimens of chronic wounds were obtained using wound exudate, the Z-technique, and the Levine technique, along with a specimen of viable wound tissue. Swab and tissue specimens were cultured using quantitative and qualitative laboratory procedures. Infected wounds were defined as those containing 1 x 10(6) or more organisms per gram of tissue. Accuracy was determined by associating the quantitative cultures of swab specimens with the cultures from tissue specimens using receiver operating characteristic curves. Of the 83 study wounds, 30 (36%) were infected. Accuracy was the highest for swab specimens obtained using Levine's technique at 0.80. Based on Levine's technique, a critical threshold of 37,000 organisms per swab provided a sensitivity of 90% and a specificity of 57%. The mean concordance between swab specimens obtained using Levine's technique and tissue specimens was 78%. The findings suggest that swab specimens collected using Levine's technique provide a reasonably accurate measure of wound bioburden, given that they are more widely applicable than tissue cultures. The diagnostic validity of Levine's technique needs further study using an alternative reference standard, such as the development of infection-related complications.

Published Article/Book Citation

The definitive version was published in Wound Repair and Regeneration, 14:5 (2006) pp.548-557. DOI:10.1111/j.1743-6109.2006.00162.x.

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URL

http://ir.uiowa.edu/nursing_pubs/126