Do you know the top 5 wound swab techniques? How should a wound swab be taken and does technique really make a difference? Nurses continue to have debate regarding the collection of wound swabs, with a common issue of debate being ‘should the swab be collected pre or post cleansing the wound surface’.
In clinical environments, a wound swab remains a common task requested of Nurses who are caring for clients with wounds that are not healing. The process is simple, noninvasive, and cost effective. If done properly, it usually identifies the bacterial species of the infection and helps direct antibiotic therapy.
Wound Swab Technique:
Whilst there is not a single definitive world wide recommended technique, the Levine’s technique, which requires the Nurse to rotate the end of the swab stick on at least 1-cm2 area of the wound bed with enough pressure to cause minimal bleeding is generally the preferred method.
Did you know the other less frequently used alternative to Levine technique is the z-track or 10-point swab culture? It’s also inexpensive. ‘However, it may yield false-positive results, especially if wound-bed cleaning and preparation are inadequate or when only a culture of surface bacteria is obtained.’
Get rid of excessive debris and dressing product residue without unduly disturbing the wound surface by using a
gentle stream of normal saline
Wait for 1 -2 minutes before taking the wound swab. This allows pathogenic organisms to rise to the surface of the wound
Take the wound swab before antiseptic solutions have been used on the wound & prior to oral antibiotics being
Take a wound swab from an area of viable tissue where the clinical signs of infection are present.
Don’t culture pooled exudate or wound dressings. The risk of non-wound contaminants is high
Use the Levine technique! A swab is rotated over at least 1cm² area of the wound surface with sufficient pressure to
express fluid from within the wound tissue
A wound swab culture might not capture bacteria protected within a biofilm, nor will it detect biofilm, so the result is often inconclusive
The Nurses for Nurses Network has a great range of Nursing Education and Nursing activities related to wound care. The sessions are focused on Nurses who need to know about managing wound care in the ‘real world’ where Nurses are often time poor and resource limited!
Swanson T, Grothier L, Schultz G. Wound Infection Made Easy. Wounds International 2014. www.woundsinternational.co2014.www.woundsinternational.com