Wound Swab Technique

Chronic wounds can develop due to illnesses, such as diabetes. Because the skin is open, bacteria can easily manifest in the wound and cause disease. All wounds require proper medical care, but chronic wounds need constant care in order to prevent infection. Many times cultures need to be taken to check for infection and this requires proper swabbing of the wound. There is a certain technique that should be followed to swab a wound properly.

Supplies

• Gather the necessary supplies ahead of time and have them ready when you begin to swab the wound. Latex-free medical exam gloves are essential for swabbing a wound. They not only protect you from contact with bacteria from the wound, but they protect the patient from acquiring germs from you. You will also need a biohazard disposal bag in which to throw away the used supplies, saline solution and sterile gauze. Obtain a culture collection and transport kit with gel for an aerobic C&S, as well as a culture collection and transport kit without gel, for obtaining a gram stain.

  An aerobic C&S is a microscopic test performed to find the presence of bacteria in the culture. A gram stain is when you use an iodine wash to determine and detect the presence of lipopolysaccharides and peptidoglycans, which are contained within the cell walls of the bacteria sample. If there are low concentrations of the lipopolysaccharides and peptidoglycans, then it is said to be gram positive. If the concentrations are high, then it is a gram negative sample.

Cleansing

• After you put on your sterile gloves, thoroughly rinse the wound with normal saline. You will want to make sure any excess debris and dirt have been irrigated out of the wound. Gently blot any excess saline off the wound with a sterile gauze. Remove your sterile gloves and discard them into a biohazard bag, wash your hands and use hand sanitizer, then put on another pair of sterile gloves, to keep from spreading any bacteria.

Swabbing

• To start, open your sterile culture collection and transport kit. Remove the swab. If the wound is dry, you will need to moisten the tip of the swab with the transport fluid you will find at the bottom of the transport sleeve. If the wound is still moist after cleansing it, you may not have to do this step. Without touching the surrounding edges of the wound, rotate the tip of swab in the wound. You will want to add a little pressure to get tissue fluid to be expressed for collection. Put the sample you collected in the transport bag, take off your gloves and wash your hands, and send the sample to the lab.

  You will need to perform these same techniques for each individual test; once for a gram stain if ordered, and separately for a C&S culture, if ordered.