Comparative study of tissue culture and sensitivity versus swab culture and sensitivity of microorganisms in the healing of diabetic foot ulcers

Abstract

This prospective observational study, conducted at the Department of General Surgery, SRM Medical College and Hospital, aimed to assess the effectiveness of tissue culture and sensitivity compared to swab culture and sensitivity in the healing of diabetic foot ulcers through antibiotic sensitivity of microorganisms. Between May 2016 and August 2017, 160 subjects with diabetic foot ulcers were randomly assigned treatment based on either swab or tissue culture findings. Patients were followed at 15-day intervals for up to 60 days. Results showed positive swab cultures in 76.88% and positive tissue cultures in 92.50% of the study population. The most prevalent organism in swab cultures was Proteus (14.38%), while Pseudomonas (16.88%) dominated in tissue cultures. The cumulative proportion of subjects developing granulation tissue was faster in the tissue culture group, reaching 57.50% at 15 to 30 days and 99% at 31 to 45 days. The swab culture group exhibited proportions of 48.80%, 75%, and 93.80% at the same intervals. In conclusion, diabetic foot ulcer treatment based on tissue culture showed slightly faster healing rates compared to swab culture. However, both groups achieved good ulcer healing within the 60-day follow-up period. These findings emphasize the importance of choosing an appropriate culture method for effective management of diabetic foot ulcers.