Question 1

All of the following are techniques for eliminating dead space in a wound EXCEPT:

Accepted Answer

Electrical nerve stimulation is not a technique for eliminating dead space in a wound. The other choices - careful approximation of tissues, placement of wound drain, and pressure dressings - are all methods used to eliminate dead space in a wound.

Question 2

A wound that is not sutured and that gradually fills in by granulation heals by which intention?

Accepted Answer

Wounds that are not sutured and heal by granulation, epithelialization, and contraction heal by second intention. This process is typical for wounds that are left open due to infection or where there is a loss of tissue.

Question 3

Which phase of healing for wounds closed by first intention begins within minutes of the incision or injury?

Accepted Answer

The inflammatory phase of wound healing begins immediately after the injury and lasts for several days. During this phase, blood vessels constrict to minimize bleeding, and then dilate to increase blood flow to the wound site. This results in the recruitment of white blood cells and platelets to the area and the formation of a blood clot to stem bleeding.

Question 4

Which type of suture needle is used on friable tissue such as liver or kidney?

Accepted Answer

Blunt needles are the best choice for friable tissue such as liver or kidney because they have a rounded tip that spreads the tissue fibers rather than cutting them, reducing the risk of tissue damage or bleeding.

Question 5

Which of the following wounds would be assigned a Class I?

Accepted Answer

Class I wounds are clean wounds, which are uninfected, with no inflammation, and the respiratory, alimentary, genital, or uninfected urinary tracts are not entered. An inguinal hernia repair with no breaks in technique fits this description.

Question 6

Which historic figure in medicine is credited with creating principles of proper tissue handling and suturing?

Accepted Answer

William Halsted is credited with creating principles of proper tissue handling and suturing, including the use of fine, non-damaging needles and aseptic technique during surgeries.

Question 7

Another name for a suture ligature is a:

Accepted Answer

A suture ligature, also known as a stick tie, involves tying a suture around a vessel or tissue to ligate it, often with a needle attached for ease of placement.

Question 8

Primary union wound healing occurs:

Accepted Answer

Primary union wound healing occurs side to side, as the edges of the wound are directly approximated and held together, allowing for minimal scarring and faster healing.

Question 9

Which tissue layer of the abdominal wall provides the greatest strength and support of the wound?

Accepted Answer

Fascia provides the greatest strength and support of the wound as it is a dense connective tissue layer that runs parallel to the skin and muscles, providing structural integrity and support to the abdominal wall. The skin, peritoneum, and subcutaneous fat do not provide as much support as the fascia.

Question 10

Evisceration of an abdominal wound is:

Accepted Answer

Evisceration refers to the protrusion of internal organs, usually the intestines, through a wound in the abdominal wall. This can occur due to inadequate closure of the surgical incision or trauma to the area. It is a serious complication and requires immediate medical attention.

Question 11

Which postoperative wound complication would require immediate surgical treatment?

Accepted Answer

Evisceration, or the protrusion of internal organs through a surgical incision, is a surgical emergency that requires immediate intervention to prevent further tissue damage or infection. Fistula, adhesions, and infection can usually be managed with non-surgical interventions before progressing to surgical management if necessary.

Question 12

Which of the following interweaves its fibers during the maturation phase of wound healing and increases its tensile strength?

Accepted Answer

Collagen is the main component of the extracellular matrix in connective tissue and provides tensile strength to the wound. During the maturation phase of wound healing, the fibroblasts secrete collagen and interweave its fibers, which increases the strength of the connective tissue. Enzymes and protein are not directly involved in increasing tensile strength, while fibrin is involved in clot formation during the inflammatory phase of wound healing.

Question 13

What is the name of a raised, hypertrophic scar due to excessive collagen formation in some darker-skinned individuals?

Accepted Answer

A keloid is a raised, hypertrophic scar due to excessive collagen formation. It is more common in individuals with darker skin tones. Cicatrix refers to any type of scar tissue, granuloma is a collection of immune cells, and seroma is a fluid-filled sac that can form after surgery or injury.

Question 14

Which type of needle is preferred for suturing of skin?

Accepted Answer

Cutting needles are preferred for suturing skin because they can easily penetrate the skin and create a clean, precise incision, allowing for more efficient closure and better wound healing. Blunt and taper needles are more suitable for internal sutures, as they are less likely to damage internal organs or tissues. Spatula needles are not commonly used in suturing.

Question 15

Inflammation can BEST be described as:

Accepted Answer

Inflammation is a normal protective response to tissue injury. It is a complex physiological response that involves multiple biochemical and cellular changes aimed at removing harmful stimuli and initiating the healing process. It is not a disease process but rather a natural defense mechanism of the body. While inflammation may result in local warmth and redness, it is not necessarily accompanied by fever, and it is not an exaggerated immune system response. However, chronic or excessive inflammation can lead to tissue damage and contribute to the development of a range of diseases.

Question 16

What kind of wound is a sacral decubitus ulcer?

Accepted Answer

Sacral decubitus ulcers, also known as pressure ulcers, are typically chronic wounds that develop over time due to pressure on the skin and tissue.

Question 17

What is the term for removal of foreign material or contaminated debris from a wound?

Accepted Answer

Debridement is the medical term used for the removal of foreign material or contaminated debris from a wound. This is done to promote healing and prevent infection. Option B (dehiscence) is the separation of the edges of a surgical incision, Option C (denuding) is the removal of the skin's top layer, and Option D (desiccation) is the process of drying out or becoming dehydrated.

Question 18

If tissue is approximated too tightly, it can result in:

Accepted Answer

If tissue is approximated too tightly, it can result in ischemia, which is a condition where there is an inadequate blood supply to the tissue. This can lead to tissue death and impaired healing. Adhesions, granulation, and keloids are all potential complications of wound healing but are not specifically related to tissue approximation.

Question 19

Tissue trauma is minimized by using which type of suture-needle combination?

Accepted Answer

A suture permanently swaged on an eyeless needle minimizes tissue trauma because it creates a smooth transition between the needle and suture, reducing drag and tissue damage.

Question 20

Which type of healing occurs in an aseptic wound with good approximation and ideal surgical conditions?

Accepted Answer

First intention healing, also known as primary healing or primary intention healing, occurs in a wound that has good approximation and ideal surgical conditions. The edges of the wound are brought together with sutures or staples, and healing occurs with minimal scar formation. This type of healing is seen in clean surgical incisions or lacerations that are closed soon after injury.

Quiz 11: Hemostasis, Wound Healing, and Wound Closure