There is an extensive table listing the preferred biopsy site for different suspected pathologies. Some of those listed include:This is probably the most important question for healthcare professionals dealing with wound care. Benefits of biopsy in a wound can be divided into 3 groups that reflect the 3 main causes of wounds in general:
1. to diagnose the etiology of a wound (wound edge),
2. to rule out malignancy (wound edge), and
3. to obtain tissue for bacterial quantitative culture or to identify an infecting organism.The next question to consider is: Are there any contraindications to wound biopsy?
There are 2 relative contraindications to wound biopsy11:
1. blood dyscrasia with the risk of uncontrollable bleeding
2. venous congestion and extremely vascular wounds (arterial insufficiency) in a setting that access to care is limited or the biopsy wound is unlikely to heal.
- Basal cell carcinoma (superficial) -- It is best to do a shave or curette biopsy of the rolled margin.
- Basal cell carcinoma (other variants) – It is best to do a deep punch or excisional biopsy of the base or wound edge.
- Squamous cell carcinoma -- It is best to do a punch or excisional biopsy of the deep wound base.
- Pyoderma gangrenosum -- It is best to do a punch or deep wedge biopsy of the wound ulcer border and center. The biopsy should include cultures to rule out infection.
- Vasculitis (large vessel) – It is best to do a deep incisional wedge biopsy of the center of the lesion. DIF (direct immunofluorescence) should be considered.