Deck 29: Wound Healing and Hemostasis

Question 1

Which is one of the four classifications of wounds?

A)Sterile
B)Clean
C)Aseptic
D)Traumatic

Answer 1

B
The wound is classified at the end of the surgical procedure as one of four types: (1)clean,(2)clean-contaminated,(3)contaminated,(4)dirty and infected.Surgical wounds are classified by the degree of microbial contamination or exposure that may predispose a patient to a postoperative wound infection.

Question 2

What type of wound healing is present when the wound is cleaned and debrided,antibiotic therapy is initiated,and a deeper and wider scar results?

A)Second intention
B)First intention
C)Third intention
D)Non-intention

Answer 2

C
Third-intention healing consists of a wound that is cleaned and debrided and packed with moist gauze to promote drainage and granulation.Antibiotic therapy is then implemented.The wound may be an old traumatic or septic wound.The area should not be devascularized,and deep sutures should be avoided.Granulomas can form in this type of wound.Two clean surfaces of granulation tissue are brought together for later closure.A deeper and wider scar usually results.

Question 3

Which is one of the three components of a three-layer dressing?

A)Small layer
B)Constrictive layer
C)Pressure layer
D)Outer layer

Answer 3

D
When moderate to heavy drainage is expected,a complete dressing consists of at least three layers: (1)contact layer,(2)intermediate layer,and (3)outer layer.The contact layer is a passageway for secretions and exudates; it may be occlusive,semiocclusive,or nonocclusive.The intermediate layer absorbs secretions passing through the contact layer.The outer layer holds the other two layers in position.

Question 4

Which is an external mechanical method of hemostasis used in the OR setting?

A)Sequential compression device (SCD)
B)Sclerotherapy
C)Thrombin
D)Oxytocin

Question 5

Which is an example of a chronic wound?

A)A wound with no local infection
B)Separation of wound edges
C)Minimal postoperative swelling
D)Ulcer or pressure sore

Question 6

___________ is characterized by swelling between fascial layers in any plane of the body.

A)Incisional infection
B)Compartment syndrome
C)Necrotizing fasciitis
D)Keloid

Question 7

What type of wound occurs after a dirty object penetrates skin and requires debridement of devitalized tissue?

A)Closed wound
B)Complicated wound
C)Contaminated wound
D)Simple wound

Question 8

Wound disruption is characterized by which of the following symptoms?

A)Bradycardia
B)Abnormal opening and exposure of the wound
C)Increased bowel gas pressure
D)Increased blood pressure

Question 9

Which is a practice associated with the insertion of drains during a surgical procedure?

A)Keep the end of the drain sterile until connected to the drainage tubing.
B)Keep only the drain and the top half of the tubing sterile.
C)Wrap tape around tubing connections to secure them.
D)Dress the drain site together with the incision site.

Question 10

What influences the ease in which a skin incision is made?

A)Type of knife handle
B)The type of surgery
C)Toughness of skin or scar tissue
D)Excess tension on the skin or wound

Question 11

In what type of wound healing is the wound left open and allowed to heal from the inner toward the outer surface?

A)Third intention
B)First intention
C)Second intention
D)Non-intention

Question 12

Which layers of skin are cut into during the initial skin incision?

A)Glabrous and hairy
B)Epidermis and dermis
C)Fascia and epidermis
D)Adipose and fascia

Question 13

What type of dressing facilitates new tissue growth and is commonly used on burn wounds?

A)Wet-to-wet
B)Wet-to-dry
C)Silicone
D)Dry sterile

Question 14

Why is a nasogastric tube inserted during an intraabdominal procedure?

A)To insert tube feeding contents
B)To insert air into esophagus
C)To aspirate stomach contents
D)To cauterize bleeding in stomach

Question 15

What is a common cause of adhesion formation?

A)Wrong type of dressing applied
B)Suture material
C)Serosal injury
D)Scar formation

Question 16

A drain can enhance wound healing by

A)preventing infection.
B)increasing wound dead space.
C)increasing seroma formation.
D)preventing tissue devitalization.

Question 17

What term defines an overgrowth of firm,rounded scar that extends beyond the border of the wound?

A)Keloid
B)Hairy skin
C)Seroma
D)Hematoma

Question 18

What are the benefits of early ambulation?

A)Increased gas pain
B)Improved circulation
C)Increased gastroparesis
D)Decreased wound pain

Question 19

What is the most important condition to promote wound healing?

A)Stop smoking
B)Young age
C)Nutritional status
D)Oxygenation of tissue

Question 20

Which is a condition that may delay wound healing?

A)Gastritis
B)Otitis media
C)Obese patient
D)Sebaceous cyst

Question 21

One main cause of wound dehiscence is

A)obesity.
B)wound infection.
C)overextended bladder.
D)perforated bowel.

Question 22

All tissues should be handled gently for complete hemostasis during the surgical procedure.

Question 23

Absorbable gelatin (Gelfoam)is placed on an area of capillary bleeding where fibrin is deposited and the sponge swells forming a clot.

Question 24

An elevated leukocyte level (white blood cell count)indicates the presence of infection.

Question 25

Radiopaque sponges are not to be used as part of the dressing.

Question 26

Hypothermia increases cellular metabolism as the body attempts to increase its warmth during a surgical procedure.

Question 27

What is the most common cause of wound infections?

A)Geriatric patient
B)Implant infection
C)Microorganisms introduced during surgery
D)Compromised patient

Question 28

Which is a preventive measure that should be followed to reduce postoperative wound infections?

A)Do not operate on infected patients.
B)Control exogenous infections.
C)Decrease number of air exchanges in the OR suite.
D)Increase turnover rate of cleaning OR suites in between cases.

Question 29

First intention wound healing is the desired method of healing after an incised aseptic wound is accurately approximated.