Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Wound Swabbing Techniques

Obtain a wound culture when clinical signs and symptoms of infection are present.

Technique:
1. Use sterile cotton-tipped swab and culture medium in a pre-packaged collection and transport system.
2. Community nurses should not allow transport medium to freeze or become overheated in the car before using it.
3. Thoroughly rinse wound with normal saline (non-bacteristatic).
4. Do not swab pus, exudate, hard eschar or necrotic tissue.
5. Rotate the swab tip in a 1cm2 area of clean granulation tissue for a period of 5 seconds, using enough pressure to release tissue exudate. This may be painful so warn the patient of the possibility of pain and pre-medicate with analgesia if possible.
6. Remove protective cap from culture medium and insert cotton-tipped applicator into the culture medium without contaminating the applicator.
7. Transport to the laboratory at room temperature within 24 hours.

Note: In Ontario, the Ontario Medical Laboratories Technologies Act, 1991 requires a health-care practitioner’s order to process the culture.

Note. From “Clinical Practice Policy and Procedure 16.2.3. Semi Quantitative Wound Swab Sample Culturing Technique,”
by C. Harris and Care Partners/ET NOW, 2000. Reprinted with permission.

Bibliography:
Dow, G., Browne, A. & Sibbald, G. (1999). Infection in chronic wounds: Controversies in diagnosis and treatment.
Ostomy/Wound Management, 45(8), 23-40.
Herruzo-Cabrera, R., Vizcaino-Alcaide, M. J., Pinedo-Castillo, C. & Rey-Calero, J. (1992). Diagnosis of local
infection of a burn by semiquantitative culture of the eschar surface. Journal of Burn Care and Rehabilitation, 13(6),
639-641.
Stotts, N. (1995). Determination of bacterial bioburden in wounds. Advances in Wound Care, 8(4), 28-46.

A Guide to Dressing Wounds
• Factors influencing dressing selection include wound type, wound depth, presence and volume of exudates, presence of infection, surrounding skin conditions, likelihood of re-injury and cost.
• Dressings should not be applied in isolation, but should be a part of a care plan consisting of debridement, pressure off-loading and when indicated, antibiotic medications.
• It is important to note that dressings themselves can be a source of pressure. Care and caution should be taken to ensure that the selected dressing does not increase pressure at the ulcer site.
• Big and bulky dressings, and donut-type devices should be avoided as they can decrease circulation to the area.

For more specific direction on dressing wounds, refer to the full guideline "Assessment and Management of Foot Ulcers for People with Diabetes, Second Edition".