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Surgical MCQs > Wound healing and its impact on dressings and postoperative care > Flashcards

Wound healing and its impact on dressings and postoperative care Flashcards

1
Q

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

A

T

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2
Q

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

A

F Because keratinocytes begin to migrate sooner.

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3
Q

Moist wound healing promotes a greater rate of vascularisation.

A

T

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4
Q

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

A

T

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5
Q

The higher bacterial count in occlusive dressings predisposes to infection.

A

F

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

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6
Q

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

A

T

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7
Q

Chronic wounds have considerably lower protease activity than acute wounds.

A

F Higher.

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8
Q

Gauze, foams and alginates are types of absorptive dressings.

A

T

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9
Q

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

A

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

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10
Q

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.

A

F

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

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11
Q

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.

A

T Only exception is when mechanical debridement is desired

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

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12
Q

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

A

T

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13
Q

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

A

T

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14
Q

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

A

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

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15
Q

Foam dressings are often used on dry wounds

A

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

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16
Q

Film dressings do not contain acrylic adhesive.

A

F They are self adhesive.

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17
Q

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

A

T Eg. Tegaderm

Generally used alone without a secondary dressing

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18
Q

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

A

T

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19
Q

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

A

F

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20
Q

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

A

F

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21
Q

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

A

T Eg. Duoderm, Comfeel.

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22
Q

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

A

F Impermeable.

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23
Q

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

A

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

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24
Q

Hydrocolloids are associated with the formation of a yellow gel.

A

T

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

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25
Q

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

A

F

26
Q

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

A

T Eg. Solosite wound gel

27
Q

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

A

T Eg. Algiste, Kaltostat.

28
Q

Alginates should not be used for heavily exuding wounds.

A

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

29
Q

Alginates have haemostatic properties.

A

T

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

30
Q

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

A

T Eg. Aquacel.

31
Q

Alginates are three times more absorbent than hydrofibre dressings.

A

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

32
Q

Alginated dressings are hydrophobic

A

F Hydrophilic

33
Q

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

A

T Eg. Aquacel Ag, Acticoat

34
Q

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

A

F Gram-positive eg. MRSA

35
Q

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

A

T

36
Q

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

A

T

37
Q

Bleeding frequently occurs after laser resurfacing

A

F Rare due to hemostatic action of the laser

38
Q

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

A

F 30-40mmHg.

39
Q

Occlusive dressings maintain a basic pH which inhibits bacterial growth

A

False

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

40
Q

Acute wound fluid stimulates DNA synthesis in cultured skin cells

A

True

Chronic wound fluid does not

41
Q

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

A 
True
Offer;
Pain relief 
Painless wound debridement 
Containment of wound exudates
Reduced complications 
Improved QoL
42
Q

Absorptive dressings include;
Gauze
Foams
Alginates

A

True

All are non-adherent fabrics

43
Q

Skin grafts and skin substitutes can be considered biologic dressings

A

True

44
Q

Occlusive non-biological dressings include traditional types and new types

A 
True
New types are
Hydrofibre dressings
Hyaluronic acid dressings 
Collagen dressings
45
Q

Hydrocolloids are new type non-biological occlusive dressings

A

False

Traditional type

46
Q

Foams and films are traditional type non-biological occlusive dressings

A 
True
These include;
Foams
Films
Hydrocolloids
Hydrogels 
Alginates
47
Q

Dressings with a moisture vapour transmission rate of

A

False

MVTR

48
Q

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

A

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

49
Q

Foams and gauze are both Absorptive and occlusive dressing types

A

False
Foams and aliginates are both types
Gauze is absorptive only

50
Q

Foam dressings may be self adhesive or non-adhesive types

A

True

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

51
Q

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

A

True

They can reduce pain from the wound while in situ

52
Q

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

A

True

53
Q

Hydrogels consist of up to 80% water

A

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

54
Q

Hydrogels are good for heavily exudative wounds

A

False

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

55
Q

Hydrogels should be changed daily

A

False

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

56
Q

Collagen dressings are derived from cow hide

A

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

57
Q

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

A

T

Accelerate the formation of granulation tissue and re-ethelialization

58
Q

Honey increases healing in venous ulcers when used with compression

A

F

59
Q

Honey may be better than conventional dressings in partial thickness burns

A

T

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

60
Q

Aloe Vera delays wound healing by secondary intention

A

True

No evidence for use of aloe Vera on skin wounds

61
Q

Cultured epidermal allografts mainly come from cadaver skin

A

False

From neonatal foreskins

Surgical MCQs (44 decks)

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