Swab cultures for diagnosing wound infections: a literature review and clinical guideline.

Infection is a major causative factor in delayed and nonhealing wounds. Indiscriminate and routine wound cultures are not recommended, but a culture is indicated to identify the causative organisms and to guide antibiotic therapy when clinical suspicion of an infection exists. Although tissue biopsy is considered the gold standard to diagnose infection, it is rarely used in clinical settings. Swab culture is the most frequently employed method of confirming wound infection in the United States, but a standardized procedure is lacking. Properly performed swab cultures provide useful data to augment diagnostic and therapeutic decision making. The specific aim of the review is to propose a research-based guideline to perform swab cultures as a basis to improve clinical practice and encourage research to establish the reliability and validity of the swab technique.