Wound Healing

Question 1

• Wound involving normal but colonized tissue
• Minor breaks in sterile technique
• Entry of GU,GI,or respiratory tract without significant spillage

Answer 1

Clean-Contaminated wound (Type II)

Question 2

• Wound containing foreign or infected material
• Traumatic wounds
• Open, fresh, accidental
  wounds
• Gross spillage from GI tract
• Entry into infected tissue,
  bone, urine, or bile

Answer 2

Contaminated wound (Type III)

Question 3

• Atraumatic, uninfected *Noentry of GU, GI, or respiratory tract
• Primarily closed
• If necessary, drained with closed drainaged

Answer 3

Clean Wound (Type I)

Question 4

• Old traumatic wounds with retained devitalized tissue and those that involve existing clinical infection or perforated viscera
• Organisms causing postoperative infection were present in the operative field before operation

Answer 4

Dirty Wound (Type I)

Question 5

Type of Wound
* Operations with major breaks in sterile technique (e.g., open cardiac massage)

Answer 5

Contaminated Wound (Type III)

Question 6

Type of Wound
* Breast surgery (MRM)
* Thyroid surgery

Answer 6

Clean wound (Type I)

Question 7

Type of Wound
*Drainage ofabscess
* Debridement of soft tissue
infection

Answer 7

Dirty wound (Type IV)

Question 8

Type of Wound
* Resection of infarcted bowel

Answer 8

Dirty wound (Type IV)

Question 9

Type of Wound:

Incisions in which acute,
nonpurulent inflammation is encountered including necrotic tissue without evidence of purulent drainage (e.g., dry gangrene)

Answer 9

Contaminated (Type III)

Question 10

Type of wound:

Operations involving biliary tract, appendix, vagina, and oropharynx (provided no evidence of infection or major break in technique is encountered)

Answer 10

Clean-Contaminated wound (Type II)

Question 11

3 Phases of Wound healing

Answer 11

1. Hemostasis & Inflammation
2. Proliferation
3. Maturation & Remodeling

Question 12

Time course of Phase 1 of Wound healing

Answer 12

7 days

Question 13

Time course of Phase 2 of Wound healing

Answer 13

5 days to 3 weeks

Question 14

Time course of Phase 3 of Wound healing

Answer 14

3 weeks to 1 year

Question 15

Clean wounds (Type I) are closed ______ to allow healing by ______

Answer 15

immediately; Primary intention

Question 16

Contaminated (Type III) or Dirty wounds (Type IV) heal by

Answer 16

Secondary intention

Question 17

Type of healing for Clean-Contaminated (type II) wounds that involves surgical toilet of open wound and closure after 48 hours

Answer 17

Tertiary closure (Delayed primary intention)

Question 18

Type of closure for wounds from traumatic injuries, dog bites, or lacerations from foreign bodies

Answer 18

Tertiary closure (delayed primary intention)

Question 19

Wounds left to heal by secondary intention are maintained on __________ phase until wound closes spontaneously

Answer 19

Proliferation

Question 20

Wounds left to heal by tertiary intention are closed after a few days when the wound is clean and __________ is abundant

Answer 20

Granulation tissue

Question 21

Pro-inflammatory interleukin that activates PMNs and induces chemotaxis

Answer 21

IL-1

Question 22

Pro-inflammatory interleukin that activates fibroblast proliferation and induces collagen and proteoglycan synthesis

Answer 22

IL-4, IL-8

Question 23

Active molecule in wound healing that activates macrophages but inhibits fibroblast proliferation

Answer 23

IFN-a

(Interferon interferes with fibroblast proliferation)