Wound healing and its impact on dressings and postoperative care

Question 1

Acute wounds have been shown to heal 40% faster in a moist environment than when air exposed.

Answer 1

T

Question 2

In moist wound healing of acute wounds, wound resurfacing occurs more rapidly because of a higher rate of mitosis.

Answer 2

F Because keratinocytes begin to migrate sooner.

Question 3

Moist wound healing promotes a greater rate of vascularisation.

Answer 3

T

Question 4

Dressings help establish a steep oxygen gradient, which stimulates capillary growth toward the more hypoxic centre.

Answer 4

T

Question 5

The higher bacterial count in occlusive dressings predisposes to infection.

Answer 5

F

Occ dressings have higher bacteria count but lower rate of infection - 2.6% compared to non occlusive dressings - 7.1%

Question 6

In contrast to acute wound fluid, chronic wound fluid is inhibitory to epithelialisation.

Answer 6

T

Question 7

Chronic wounds have considerably lower protease activity than acute wounds.

Answer 7

F Higher.

Question 8

Gauze, foams and alginates are types of absorptive dressings.

Answer 8

T

Question 9

Hydrophilic types of non-adherent fabrics have greater occlusive capability, but hinder fluid drainage through them.

Answer 9

F
This is true for hydrophobic dressings, such as Telfa, Xeroform, Vasgauze, Jelonet, Bactigras (same as the others but impregnated with chlorhexidine)

Question 10

Hydrophobic types of non-adherent dressings are less occlusive, but have the ability to readily facilitate the drainage of fluids and exudates into overlying dressings.

Answer 10

F

This is true for hydrophilic dressings eg. Mepitel, Adaptic, Xeroflo

Question 11

Wide mesh gauze is usually not placed in direct contact with wounds because it adheres to the surface of the wound, resulting in pain on removal.

Answer 11

T Only exception is when mechanical debridement is desired

Gauze usually used over non-adherent, non-occlusive fabric dressings such as Xeroform

Question 12

Foam dressings and alginates are both absorptive and occlusive/moisture-retentive dressings.

Answer 12

T

Question 13

The moisture vapour transmission rate of wounded skin is 40 times higher than intact normal skin.

Answer 13

T

Question 14

The primary advantage of foam dressings are that they can be used on wounds with unusual configurations and are highly absorptive.

Answer 14

T Eg. Allevyn, Mepilex
Should cover a 2cm margin around the wound edges
Too drying to use as primary dressing on dry wounds

Question 15

Foam dressings are often used on dry wounds

Answer 15

F Because of their dehydrating capabilities they are not used on dry wounds

Question 16

Film dressings do not contain acrylic adhesive.

Answer 16

F They are self adhesive.

Question 17

Film dressings are permeable to oxygen, carbon dioxide and water, and impermeable to fluids and bacteria.

Answer 17

T Eg. Tegaderm

Generally used alone without a secondary dressing

Question 18

The biggest disadvantage of film dressings is that they are non-absorptive, therefore fluid can collect under them.

Answer 18

T

Question 19

Film dressings are recommended for patients with fragile skin, such as the elderly.

Answer 19

F

Question 20

Film dressings should be used as the primary dressing of moderately to heavily exuding or infected wounds, sinus tracts, or cavities

Answer 20

F

Question 21

Hydrocolloid dressings contain a hydrocolloid matrix consisting of materials such as gelatin, pectin, and carboxymethylcellulose.

Answer 21

T Eg. Duoderm, Comfeel.

Question 22

Hydrocolloid dressings are permeable to water vapour, oxygen and carbon dioxide.

Answer 22

F Impermeable.

Question 23

Hydrocolloids may initially cause the size of the wound to increase.

Answer 23

T Due to their debriding abilities. The skin around them may macerate
Can be reduced by applying zinc oxide to the wound margins

Question 24

Hydrocolloids are associated with the formation of a yellow gel.

Answer 24

T

Gel has an unpleasant odour and can be confused with wound infection

Question 25

Hydrocolloids are the dressing of choice for third degree burns and actively infected ulcers

Answer 25

F

Question 26

Hydrogel dressings are available as gels, sheets or impregnated gauze.

Answer 26

T Eg. Solosite wound gel

Question 27

Alginate dressings consist of the soft non-woven fibres of a cellulose-like polysaccharide derived from the calcium salt of seaweed.

Answer 27

T Eg. Algiste, Kaltostat.

Question 28

Alginates should not be used for heavily exuding wounds.

Answer 28

F Good for these but hydrofibre dressings better as more absorptive Should not be used on dry or mildly exuding wounds

Question 29

Alginates have haemostatic properties.

Answer 29

T | They form a gel after absorbing blood which can be foul smelling and mimic wound infection

Question 30

Hydrofibre dressings are composed of soft, absorbent carboxymethyl cellulose fibres that interact with wound exudates to form a soft gel.

Answer 30

T Eg. Aquacel.

Question 31

Alginates are three times more absorbent than hydrofibre dressings.

Answer 31

F Other way around Hydrofibre best choice for heavily exuding wounds Hydrofibre ribbons used to pack wound cavities

Question 32

Alginated dressings are hydrophobic

Answer 32

F Hydrophilic

Question 33

Silver-impregnated dressings are bactericidal without antibiotics and maintain a moist environment to facilitate wound healing.

Answer 33

T Eg. Aquacel Ag, Acticoat

Question 34

Maggot therapy is most efficacious in wounds infected with Gram-negative bacteria.

Answer 34

F Gram-positive eg. MRSA

Question 35

The closed technique of wound dressing after laser surgery is associated with more rapid re-epithelialisation and less pain than the open technique.

Answer 35

T

Question 36

After laser resurfacing there is pain, burning and stinging for the first few days, and during the first 1-2 days there is oozing of thermally denatured collagen

Answer 36

T

Question 37

Bleeding frequently occurs after laser resurfacing

Answer 37

F Rare due to hemostatic action of the laser

Question 38

The recommended ankle pressure in patients with venous ulcers of the leg is 50-60mmHg.

Answer 38

F 30-40mmHg.

Question 39

Occlusive dressings maintain a basic pH which inhibits bacterial growth

Answer 39

False | Mildly acidic pH which inhibits growth of some bacteria eg staph and pseudomonas

Question 40

Acute wound fluid stimulates DNA synthesis in cultured skin cells

Answer 40

True | Chronic wound fluid does not

Question 41

Moisture retentive occlusive wounds offer advantages for chronic wounds such as venous ulcers

Answer 41

``` True Offer; Pain relief Painless wound debridement Containment of wound exudates Reduced complications Improved QoL ```

Question 42

Absorptive dressings include; Gauze Foams Alginates

Answer 42

True | All are non-adherent fabrics

Question 43

Skin grafts and skin substitutes can be considered biologic dressings

Answer 43

True

Question 44

Occlusive non-biological dressings include traditional types and new types

Answer 44

``` True New types are Hydrofibre dressings Hyaluronic acid dressings Collagen dressings ```

Question 45

Hydrocolloids are new type non-biological occlusive dressings

Answer 45

False | Traditional type

Question 46

Foams and films are traditional type non-biological occlusive dressings

Answer 46

``` True These include; Foams Films Hydrocolloids Hydrogels Alginates ```

Question 47

Dressings with a moisture vapour transmission rate of

Answer 47

False | MVTR

Question 48

Wounded skin has a moisture vapour transmission rate of 200g/m2

Answer 48

False This is for intact normal skin Wounded skin MVTR is 40x higher than this

Question 49

Foams and gauze are both Absorptive and occlusive dressing types

Answer 49

False Foams and aliginates are both types Gauze is absorptive only

Question 50

Foam dressings may be self adhesive or non-adhesive types

Answer 50

True | Can be used as primary dressing or secondary dressing to provide additional absorption or protective cushioning

Question 51

Film dressings may be left in place for several days until a pocket of fluid accumulates under the dressing

Answer 51

True | They can reduce pain from the wound while in situ

Question 52

When applying a hydrocolloid dressing the warmth of the hand can be used to help seal the dressing

Answer 52

True

Question 53

Hydrogels consist of up to 80% water

Answer 53

True Hydrophilic polymer + water Polymer is usually starch type such as polyethylene oxide

Question 54

Hydrogels are good for heavily exudative wounds

Answer 54

False | Good for superficial wounds with mild exudate such as post dermabrasion or peel or for dry or necrotic wounds

Question 55

Hydrogels should be changed daily

Answer 55

False | Change every 3 days for necrotic wounds and every 7 days for granulating wounds

Question 56

Collagen dressings are derived from cow hide

Answer 56

T Consist of type 1 bovine collagen Provide a collagen matrix for cellular migration

Question 57

Hyaluronic acid dressings are biodegradable absorbent polymers that form a hydrophilic gel with the wound exudate

Answer 57

T | Accelerate the formation of granulation tissue and re-ethelialization

Question 58

Honey increases healing in venous ulcers when used with compression

Answer 58

F

Question 59

Honey may be better than conventional dressings in partial thickness burns

Answer 59

T | But delays healing when compared with early excision and grafting of partial and full thickness burns

Question 60

Aloe Vera delays wound healing by secondary intention

Answer 60

True | No evidence for use of aloe Vera on skin wounds

Question 61

Cultured epidermal allografts mainly come from cadaver skin

Answer 61

False | From neonatal foreskins