General Nursing (RGN)
TAKING A WOUND SWAB
A wound swab collects a representative specimen for microbiological investigation when infection is suspected or testing is prescribed. The wound is cleansed first, the swab is taken from viable tissue using an approved technique, and the specimen is labelled and transported promptly.
Purpose
- Identify organisms associated with a wound infection
- Guide antimicrobial selection and other treatment
- Support investigation of delayed healing or unexpected exudate
Indications
- Clinical signs of wound infection or deterioration
- A prescribed culture and sensitivity or microbiology test
- A wound with new purulent exudate, malodour, increasing pain, or spreading inflammation
Equipment
- Appropriate sterile swab and transport medium
- Sterile normal saline or prescribed cleanser
- Sterile gauze and dressing supplies
- Clean and sterile gloves
- PPE and waste bags
- Specimen label and completed laboratory request form
- Kidney dish and trolley
Preparation
- Review the wound history, prior cultures, antimicrobial therapy, and pain score.
- Check the transport medium expiry date and the laboratory’s transport time requirements.
Procedure steps
- Verify the order, specimen type, patient identity, allergies, and any antimicrobial treatment already given.
- Explain the reason for the swab, obtain consent, assess pain, and provide prescribed analgesia before the procedure if needed.
- Perform hand hygiene, prepare the equipment, provide privacy, and position the patient to expose the wound safely.
- Put on clean gloves, remove the old dressing, observe the wound, and dispose of the dressing appropriately.
- Remove gloves, perform hand hygiene, and put on sterile gloves or use the laboratory-approved aseptic technique.
- Cleanse the wound with sterile saline and remove excess fluid with sterile gauze; do not swab pooled exudate or surrounding skin.
- Rotate the sterile swab over a small area of clean viable tissue using sufficient pressure to obtain specimen, following local laboratory technique.
- Avoid touching the swab to the wound edge, surrounding skin, trolley, or any non-sterile surface.
- Place the swab immediately into its transport medium, secure the lid, label it at the bedside, and complete the request form.
- Complete the dressing, remove PPE, perform hand hygiene, send the specimen promptly, and document the wound assessment and specimen collection.
Precautions
- Collect before starting antibiotics when clinically possible, but never delay urgent treatment while waiting for a swab.
- A superficial swab of pus or an unclean wound may reflect colonization rather than the infecting organism.
- Do not touch the swab tip or reuse a swab that has contacted a non-sterile surface.
- Follow laboratory requirements for anaerobic, viral, fungal, or special specimens.
Documentation
- Record wound appearance, site sampled, cleansing solution, time collected, antimicrobial status, and patient tolerance.
- Document specimen label and request completion, dispatch time, and any escalation for infection.
Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.
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