Wound Culture
| PATIENT INFO |
| Patient Name: |
| Medical Record #: |
| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
| Address: |
| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
| Ph: ( ) - Fax: ( ) - |
| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Wound Culture | |
| 2. | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
WOUND
Test Workstation :
MIC2
Specimen Type:
Eswab collected from wound lesion or abscess.
Cause for Rejection:
Quantity not sufficient, improper specimen type, improper storage/transport, improper swab, dry swab, swab not present, multiple swabs per vial, mislabeled, or unlabeled.
Storage:
Transport at room temperature. Upon arrival in laboratory, store refrigerated.
Availability:
Mon-Sun (0700-1600)
Methodology:
Culture
Special Instructions:
Requisition or audit trail must specify type and source (e.g. Swab, right eye) of specimen along with important information regarding patient diagnosis (e.g. animal bite).
Cleanse the skin prior to collection. Let dry for 30 seconds. Remove the swab from the collection kit package. Swab the surface of the skin or wound, collecting exudate if present. If a vesicle is present, collect both fluid and cells from the base of the lesion. Break off swab at the red score line into the transport tube containing 1.0mL liquid media.
Cleanse the skin prior to collection. Let dry for 30 seconds. Remove the swab from the collection kit package. Swab the surface of the skin or wound, collecting exudate if present. If a vesicle is present, collect both fluid and cells from the base of the lesion. Break off swab at the red score line into the transport tube containing 1.0mL liquid media.
Lab/Phone:
330-543-8406
TAT:
4 days
Additional Info:
All wound cultures include a gram stain.
CPT Code:
87070
Synonyms:
Abscess Culture; Lesion Culture
