A complete bacteriological study was made of skin ulcerations associated with peripheral vascular disease in 40 consecutive untreated patients, and a method of colony counting was devised. In all but five ulcers, thee was bacterial growth of at least 2,000 colonies per milliliter of water, and the total count was not well correlated with the presence or absence of clinical signs of inflammation. Staphylococcus aureus and the Enterobacteriaceae were most common in the ulcers appearing clinically inflamed whereas the indolentappearing ulcers tended to have less virulent organisms.
Further work is necessary to determine whether the surface infection found in clinically inflamed ulcers is significant and warrants antibacterial therapy.
Friedman SA, Gladstone JL. The Bacterial Flora of Peripheral Vascular Ulcers. Arch Dermatol. 1969;100(1):29-32. doi:10.1001/archderm.1969.01610250035008