COMPARATIVE STUDY OF SWAB VERSUS BIOPSY OF BURNS WOUNDS IN A TERTIARY CARE HOSPITAL IN HYDERABAD

Introduction: Burn injury is a major problem in many parts of the world. It has been estimated that 75% of all deaths following burns
are related to infection. Thermal injury destroys the skin barrier that normally prevents invasion by microorganisms. Individual
organisms are brought into the burns ward on the wounds of new patients. These organisms then persist in the resident flora of the
burn treatment facility for a variable period of time, only to be replaced by newly arriving microorganisms. Introduction of new
topical agents and systemic antibiotics influence the flora of the wound.
Materials and methods: The study group consists of 100 patients admitted to burns ward in a tertiary care hospital. Surface wound
swab, biopsy, blood and urine samples were collected under aseptic precautions. The samples were inoculated onto blood agar, Mac
Conkey agar and the isolates were identified by standard biochemical tests. Antibiotic sensitivity was performed.
Results: Out of 100 patients admitted, 62 were females and 38 males. Female to male ratio was 1.5:1.
of all the age groups, patients in the age group of 16-25yrs were more susceptible. Burn injuries with %TBSA of 31-40% were more
common.(29%)49% of the wounds were infected on day 7 while 62% of the wounds were infected on day 14 The concordance rates
of swab and biopsy on 7th and 14th day were 83.3% and 65% respectively. Klebsiella spp. was the most common organism isolated
among all samples followed by Staphylococcus aureus.
Conclusion: Females constitute a major proportion of victims of burn injuries. People in the age group of 16-25yrs were more
susceptible. Burn injuries were more common due to flames where suicidal burns constituted the major proportion. Swab sampling
can be considered a good tool for monitoring burn wounds within the first week of treatment and could defer the need for invasive
biopsy sampling. But for patients who remain in the burns ward for a longer period, biopsy samples are justified as it gives the
microbial load in the tissue.