Tests
1st tests to order
clinical diagnosis
Test
Diagnostic tests are not used to make the diagnosis of pressure ulcers.
Certain tests may help in diagnosing complications of pressure ulcers including wound infection and osteomyelitis.
Result
features of pressure ulcer
Tests to consider
wound swab
Test
Often done when signs of infection are evident. However, while commonly used, wound swabs have not been shown to be useful in the management of potential infected pressure ulcers.
Culture results often reflect colonization and not actual infection. Consequently, guidelines do not recommend routine use of wound swabs.[17]
Result
positive culture in infection
ESR
Test
Suggests osteomyelitis; not confirmatory of pressure ulcer.
Result
>100 mm/hour in osteomyelitis
WBC
Test
Suggests osteomyelitis; not confirmatory for pressure ulcers.
Result
>15,000/microL in osteomyelitis
serum glucose
Test
To exclude diabetes.
Result
elevated in diabetes
deep tissue biopsy
Test
The definitive method for diagnosing infection. Not always practical in a clinical setting. Diagnosing infection is a clinical skill rather than a microbiologic technique.[56]
Result
evidence of infection
MRI
Test
Appropriate whenever bony involvement is possible; not confirmatory for pressure ulcers.
Result
evidence of bony involvement
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