Pressure Sore

Question 1

bed sores, or decubitus ulcers,
these wounds can occur anywhere on the body when there is
increased pressure or friction, shearing forces, or limb spasticity

Answer 1

T

Question 2

The risk is even more pronounced in the SCI population, in which there is an estimated incidence of 20% to 30% in paraplegic and quadriplegic patients

Answer 2

T

Question 3

no known direct evidence
linking urinary or fecal incontinence with the direct formation of
pressure-related injuries themselves.

Answer 3

T

Question 4

Avoid bedside swab of wounds due to contamination; intraoperative deep cultures are superior for antibiotic tailoring

Answer 4

T

Question 5

MRI may be indicated to evaluate extent of osteomyelitis

Answer 5

T

Question 6

Spasm and contracture create shear forces contributing to
pressure injury development

Answer 6

T

Question 7

Antispasmodic pharmacotherapy: badofen, diazepam,
dantrolene

Answer 7

T

Question 8

Botulinum toxin improves function and reduces limb spasticity with minimal side effects

Answer 8

T

Question 9

hydrogels during the debridement stage

Answer 9

T

Question 10

foam and
low-adherence dressings for the granulation stage

Answer 10

T

Question 11

hydrocolloid
and low-adherence dressings for the epithelialization stage

Answer 11

T

Question 12

Diluted
sodium hypochlorite solution has been shown to be bactericidal with fibroblast preservation.

Answer 12

T

Question 13

Hydrocolloid dressing has been associated with almost three
times more complete healing compared with the use of saline gauze alone

Answer 13

T

Question 14

Honey-variable gel thickness and composition, minimal
risk, and low cost, with possible autolytic and antimicrobial
properties

Answer 14

T

Question 15

Studies on sustained silver-releasing dressing demonstrated
a tendency for reducing the risk of infection and promoting
faster healing

Answer 15

T

Question 16

use of alginates with hydrogel results in significantly
greater reduction in the size of stage 3 and 4 pressure injuries compared to hydrocolloid alone

Answer 16

F use of alginates with hydrocolloid results in significantly
greater reduction in the size of stage 3 and 4 pressure injuries compared to hydrocolloid alone

Question 17

benefits of VAC

Answer 17

removal of infectious materials,36 reduced risk of compromise due to contamination,
the ability to solubilize necrotic tissue, reduced volume of exudate, increased granulation tissue, and decreased wound size

Question 18

Contraindications to the use of NPWT include

Answer 18

exposed vessels or organs, nonenteric and unexplored fistulas, malignancy, and untreated osteomyelitis

Question 19

A pressure injury itself is an indication of HBOT

Answer 19

F A pressure
injury itself is not an indication for HBOT

Question 20

HBOT may be
used as adjunctive treatment for chronic refractory osteomyelitis within a pressure injury or a failed graft or flap.

Answer 20

T

Question 21

The efficacy of platelet-derived growth factors, fibroblast growth
factor, and granulocyte macrophage colony stimulating factor in
improving complete pressure injury healing has not been well established.

Answer 21

T

Question 22

There is some evidence that electrotherapy41 and whirlpool therapy4’
may help reduce the size and surface area of stage 2 to 4 pressure injuries

Answer 22

T

Question 23

rate
of osteomyelitis

Answer 23

with 56% of primary injuries and 79% of recurrent
injuries

Question 24

Avoid radical ostectomy for bony prominences WHY?

Answer 24

skeletal instability, excessive bleeding, and
pressure point redistribution

Question 25

There is no reported difference in success using myocutaneous compared to fasciocutaneous flaps

Answer 25

T

Question 26

Recurrence rates of 19% to 33% have been reported for ischial pressure injuries after flap reconstruction

Answer 26

T

Question 27

Tensor fascia lata (TFL) may be considered, but it may be too thin distally

Answer 27

T

Question 28

Consider flaps that can be readvanced subsequently: for example gluteal rotation or V-Y hamstring. for ischium

Answer 28

T

Question 29

For Sacrum

Answer 29

Most common musculocutaneous flap is based on gluteus maximus muscle. Can be superior or inferiorly based, with ability to rotate, advance, or turnover.

Question 30

A fasciocutaneous flap or partial gluteus muscle may be needed in ambulatory patient as gluteus maximus muscle is not expendable.

Answer 30

T

Question 31

Recurrence rates 17% to 21% depending on flap choice

Answer 31

T

Question 32

Trochanter

Answer 32

Flap reconstruction most commonly TFL, but pedicled ALT flap is also an option

Question 33

TFL blood supply consistent from underlying TFL muscle, but distal part of flap is random blood supply that may need to be delayed

Answer 33

T

Question 34

Ifthere is a SCI below L3, the TFL can be sensate via Ll-L3 by way of the lateral femoral cutaneous nerve

Answer 34

T

Question 35

Heels may require lifelong wound care, free flap coverage, or amputation depending on patient functional status and comorbid state

Answer 35

T

Question 36

VTE has been reported as high as 11% in the acute SCI population, despite receiving VTE prophylaxis

Answer 36

T

Question 37

pallor. Patients with lesions above T6 are particularly susceptible to autonomic dysrefelxia

Answer 37

T

Question 38

Perioperative blood transfusion is RISK FACTORS FOR POSTOPERATIVE COMPLICATIONS

Answer 38

T

Question 39

Patients who develop a pressure injury in an ICU setting have in-hospital mortality rates as high as 48%

Answer 39

T

Question 40

Age above 65 years, diabetes, and total functional dependency were associated with increased mortality risk

Answer 40

T