T. S. Lim MB BS, Grad Dip Surg Anat; B. P. Mwipatayi MMed (Surg), FCS (SA), Cert. Vascular Surgery (SA); R. Murray MB BS, MRCP (Ireland), DTM and H (Liverpool), FRACP, FRCPA; K. Sieunarine FRCS, FRACS; M. Abbas MS, FVES; D. Angel BAppSci.
MICROBIOLOGICAL PROFILE OF CHRONIC ULCERS OF THE LOWER LIMB: A PROSPECTIVE OBSERVATIONAL COHORT STUDY
Article first published online: 3 AUG 2006
ANZ Journal of Surgery
Volume 76, Issue 8, pages 688–692, August 2006
How to Cite
Lim, T., Mwipatayi, B., Murray, R., Sieunarine, K., Abbas, M. and Angel, D. (2006), MICROBIOLOGICAL PROFILE OF CHRONIC ULCERS OF THE LOWER LIMB: A PROSPECTIVE OBSERVATIONAL COHORT STUDY. ANZ Journal of Surgery, 76: 688–692. doi: 10.1111/j.1445-2197.2006.03832.x
- Issue published online: 3 AUG 2006
- Article first published online: 3 AUG 2006
- Accepted for publication 19 February 2006.
- leg ulcers;
Background: The aim of the study was to determine the microbiological profile of chronic lower-limb ulcers in a tertiary outpatient setting.
Methods: A prospective observational cohort study of 39 patients with lower-limb ulcers of more than 1 month duration, presenting to the leg ulcer clinic. Superficial swab and punch biopsy samples were taken from each ulcer.
Results: Mean age was 68.7 years. Venous ulcers were most common (51%) followed by arterial ulcers (13%), ulcers inpeople with diabetes having arterial disease (13%), unspecified ulcers (13%) and ulcers in people with diabetes (10%). The most common organisms were Staphylococcus aureus (38–44%) followed by Pseudomonas aeruginosa (26–28%). Biopsy and swab results were concordant in 18 (46%), had at least one organism in common in 10 (26%) and had no concordance in 11 (28%). Histological analysis did not show any cases of malignancy. Ulcer area was significantly lower after 2 months of treatment (P = 0.047). Venous ulcers had the best outcome at 2 months, whereas people with diabetes with arterial disease fared poorly.
Conclusion: The microbiological profile of chronic leg ulcers has application to general treatment principles as well in guiding the necessity and choice of antibiotic therapy. Concordance between swab and biopsy results was poor; we recommend biopsy in the tertiary setting.