Rondas AA, Schols JM, Halfens RJ, Stobberingh EE, et al.
Advances in skin & wound care. Date of publication 2013 May 1;volume 26(5):211-9.
1. Adv Skin Wound Care. 2013 May;26(5):211-9. doi:
10.1097/01.ASW.0000428984.58483.aa.
Swab versus biopsy for the diagnosis of chronic infected wounds.
Rondas AA(1), Schols JM, Halfens RJ, Stobberingh EE.
Author information:
(1)De Zorggroep, Venlo, The Netherlands.
OBJECTIVE: The goal of this review was to investigate the usefulness of a wound
swab (using the Levine or Z technique) in comparison with a biopsy as a reliable
method for the diagnosis of a chronic wound infection.
METHOD: A literature review using the electronic databases PubMed, CINAHL, and
MEDLINE were searched by strategy. A total of 6 articles fulfilled the inclusion
criteria.
MAIN RESULTS: The Levine technique detects more organisms in acute wounds, as
well as in chronic wounds, than the Z technique. Comparing both with the biopsy
as criterion standard, the diagnostic accuracy to diagnose a chronic wound
infection by the Levine technique was higher in comparison to the Z technique. At
a threshold of 3.7 × 10(4) microorganisms per swab, the Levine technique had a
sensitivity of 0.90, a specificity of 57%, and a positive predictive value and
negative predictive value of 0.77 and 0.91, respectively. Description of the
method of swab taking was diverse and not uniform.
DISCUSSION: Only a few studies in the literature compare wound swabs with
biopsies for the diagnosis of chronic infected wounds. Until now, the Levine
technique has been considered as the most reliable and valid method, but there is
an urgent need for a well-designed study with a sufficient number of patients to
optimize the diagnostic accuracy of chronic infected wounds.
CONCLUSION: The best sampling technique for taking a swab has not yet been
identified and validated. Until then, the authors recommend the Levine technique.
DOI: 10.1097/01.ASW.0000428984.58483.aa
PMID: 23591095 [Indexed for MEDLINE]
