Publication

Abstract : Background: Venous ulcer is the long-term resultant morbidity of chronic venous disease. While it is believed to be of non-infectious aetiology, unlike diabetic foot ulcers, wound healing can be delayed in case of colonizing bacteria, and polymicrobial flora can further hinder the process. Aim -To identify the bacterial profile of infection in chronic venous ulcers and its significance in managing chronic venous ulcers. Material and Methods: This prospective observational study included 150 patients with Chronic Venous Leg Ulcers (CVLU) who had undergone treatment at our institution. A wound swab for culture was taken from the venous ulcer for microbiological sampling. Antibiotics were prescribed asper the culture sensitivity of bacteria. Treatment protocols for managing all venous ulcers were four-layer compression bandages with weekly dressing changes. The endpoint was the healing of the ulcer. The statistical significance of the association of microbiological sampling in diagnosing and managing chronic venous ulcers and secondary objectives was assessed using the chi-square test with “Fisher’s exact test”. Results: The mean size of the ulcer was 12.08 mm. Microbiological culture yielded growth of organisms in 137 (91%) patients, and of these, 78 (56.9%) were monomicrobial, and 59 (43.1%) were polymicrobial. There were 69 patients harbouring multi-drug resistant bacteria, which included Staphylococcus aureus (MRSA) (n=33) and Pseudomonas aeruginosa (n=36). Patients with evidence of infection showed a lower partial and complete response rate. Staphylococcus aureus, Pseudomonas spp (all species), and Klebsiella spp infections reduced early response rates compared to overall responses. Conclusion: A positive culture from the wound decreases the chances of and prolongs wound healing time. Early and appropriate antibiotic therapy in culture-positive patients hastens the time of healing