Fine-needle Aspiration Biopsy, Curettage, and Swab Samples in Bacteriologic Analysis of Leg Ulcers

To the Editor.— The incidence of leg ulcers increases with age. Insufficient venous circulation of the lower extremities is the main reason for leg ulcers. The role of bacteria in the pathogenesis or healing process is not known. Swabs or curettage samples are most commonly taken for evaluation of the bacterial flora. 1,2 To avoid the effect of the superficial flora on the results, saline aspiration has been recommended to sample bacteria inside the inflamed tissue around the ulcer. 3 We found the saline aspiration technique unreliable; the 0.5 to 2.0 mL of saline needed for aspiration was dissipated into the tissues too often, and sufficient aspirate was not obtained. The purpose of this study was to assess fine-needle aspiration biopsy (FNAB) as the method of the bacteriologic evaluation of leg ulcers. Patients and Methods.— Thirty-one consenting patients with leg ulcers were studied (age range, 46 to 95 years; average age, 70.5