The post-it reads “Hey doc, are you expecting a different result from a mm away?”
A culture is a lab test that tests for infection in a location where the culture is taken from.
This location can be anywhere in the body. I’ve done cultures on abscesses from the top of a patient’s head all the way down to their toes. Different patients, mind you.
The reason behind doing a culture is twofold. It lets the lab and the surgeon identify the particular pathogen that is causing the infection. It also allows the surgeon to order the correct antibiotics targeting the pathogen. A third possibility is that there is no infection that is causing the symptoms. However, even that is an answer. A negative result and lack of a pathogen is still an answer.
However, this post is about a surgeon who is culture happy. They culture everything. And I mean, everything. Oftentimes there are multiple cultures, within the same geographical area on the body.
My question to that surgeon is why run these expensive tests when the area that is cultured is essentially the same place. I do understand pre and post-lavage cultures. This is when the body part is cultured before irrigation and after to see if there are any lingering bits after being sprayed with the equivalent of a garden hose.
What I don’t understand is the multiple cultures after the incision and before the irrigation. Please help me understand why this is routine for the culture happy surgeon.
Is the pathogen just under incision different than the pathogen 1 mm in? I guess it could be. Especially when there is a verifiable pocket of pus that looks different. And I understand culturing separate body parts, such as the heel of the foot and the knee. But how often does that happen?
And at what a cost to the patient?
Dispatches from the Evening Shift 