Pathlab update: Diagnostic stewardship, wound swabs

Pathlab has reviewed the clinical indications for wound swabs and updated its guidance to support good diagnostic stewardship.

There are a limited number of scenarios where sending a wound swab to the laboratory adds genuine clinical value, including:

• wound infection with systemic signs such as fever or tachycardia
• infected wounds not responding to standard empiric treatment
• infected post-surgical, bite, burn, or penetrating wounds
• diabetic foot infection
• infected skin grafts
• extensive infected eczema or impetigo
• abscesses recurring after drainage or presenting with systemic signs
• wound infection in the presence of significant immunocompromise.

The e-ordering clinical indication menu for wound swabs will be updated to reflect these indications.

Outside of these scenarios, wound swabs have limited diagnostic value and should be sent rarely. In particular, swabs from chronic ulcers and peri-anal or groin areas are almost inevitably colonised with enteric flora and should only be sent to the laboratory under exceptional circumstances.

Practices are asked to adhere to these recommendations and to ensure this update is shared with all relevant members of their team.

Please send feedback to info@pathlab.co.nz.