A concern on investigation into the microbiological status of ‘locally infected’ leg ulcers

Abstract

Editor, I read the recent report by Cooper et al.(1) on the microbiological status of locally infected leg ulcers with great interest. In this work, Cooper et al. compared three sampling techniques and concluded that ‘No justification for using routine biopsies in locally infected venous leg ulcers was found (1)’. There are some points to be concerned in this work. First, the possibility of pre-pre-analytical and pre-analytical errors in this study should be mentioned. The difference in patient underlying status as well as the difference in patient preparation before sampling might be a big pre-pre-analytical interference. Focusing on the pre-analytical phase, the quality control in specimen collection and transportation might be a big problem. Interpersonal variation in sampling process should be well controlled. Second, quality control of the microbiological laboratory in this work is not well clarified. Third, although the biopsy might not be a good sampling in this study, it is still useful in giving other additional information such as non infectious histological disorders and malignant changes (2). Viroj Wiwanitkit MD 1