A prospective study of the microbiology of chronic venous leg ulcers to reevaluate the clinical predictive value of tissue biopsies and swabs
- 23 January 2007
- journal article
- clinical trial
- Published by Wiley in Wound Repair and Regeneration
- Vol. 15 (1), 17-22
- https://doi.org/10.1111/j.1524-475x.2006.00180.x
Abstract
This study determined whether comprehensive microbiological analysis offered real predictive value in terms of healing outcome, and assessed the clinical usefulness of surface swabs vs. tissue biopsies for clinically noninfected leg wounds. The wound microflora of 70 patients with chronic venous leg ulcers was quantified after sampling by swabbing and biopsy. A highly significant association between wound surface area at 4 weeks and eventual healing at 6 months was found (p0.1). A significant association between healing and bacterial diversity in the wound as assessed by swab (p=0.023) was demonstrated. Furthermore, the bacterial density of wound surface area by swab (CFU/mL; p=0.018) or biopsy (CFU/g tissue; p=0.038) were shown to be independent predictors of nonhealing. Logistic regression showed that microbiological analysis of biopsies provided no additional prognostic information when compared with analysis of the surface microflora (p=0.27). Hence, if biopsies do not contribute significantly to patient management, their use should be discouraged in clinically noninfected wounds. Furthermore, independent predictors of healing, such as wound surface microbial diversity and density, could identify patients likely to have an unfavorable outcome and to whom resources should be targeted.Keywords
This publication has 20 references indexed in Scilit:
- Use of 16S Ribosomal DNA PCR and Denaturing Gradient Gel Electrophoresis for Analysis of the Microfloras of Healing and Nonhealing Chronic Venous Leg UlcersJournal of Clinical Microbiology, 2004
- Molecular analysis of the microflora in chronic venous leg ulcerationJournal of Medical Microbiology, 2003
- Wound Microbiology and Associated Approaches to Wound ManagementClinical Microbiology Reviews, 2001
- Bacterial colonization and healing of venous leg ulcersAPMIS, 1996
- The clinical importance of gram-positive anaerobic cocci isolated at St Bartholomew's Hospital, London, in 1987Journal of Medical Microbiology, 1994
- What is infection?The American Journal of Surgery, 1994
- THE EFFECT OF BACTERIAL COLONIZATION ON VENOUS ULCER HEALINGAustralasian Journal of Dermatology, 1992
- Quantitative microbiology of pressure sores in different stages of healingDiagnostic Microbiology and Infectious Disease, 1986
- The Clinical Significance of Bacterial Growth in Venous Leg UlcersScandinavian Journal of Infectious Diseases, 1984
- Probable Inference, the Law of Succession, and Statistical InferenceJournal of the American Statistical Association, 1927