Wounds

Question 1

T/F: Polyvinylpyrrolidone (betadine) kills microorganisms by disruption of protein and nucleic acid structures.

Answer 1

True

Question 2

T/F: Polyvinylpyrrolidone (betadine) is one of the most effective antiseptics against methicillin-resistant Staphylococcus aureus

Answer 2

True

Question 3

T/F: Polyvinylpyrrolidone (betadine) has a broad antimicrobial spectrum compared to other agents

Answer 3

True

Question 4

T/F: Dilution of 10% Polyvinylpyrrolidone (betadine) results in less free iodine than the undiluted colution, leading to decreased bactericidal activity

Answer 4

False; the 10% betadine solution contains insufficient free iodine to kill bacteria. Dilution liberates more free iodine, making the dilutes solution more bactericidal.

Question 5

Lacterations involving less than ____% of the tongue’s thickness can be left to heal by second intention, but deeper lacerations should be sutured.

Answer 5

30%???

Question 6

The sensory and motor supply to the eyelid are important considerations when repairing eyelid lacerations. What nerves supply sensory innervation tot he lateral canthus?

Answer 6

Lacrimal and zygomatic

Question 7

What is the term used to describe the source of passive nourishment for newly applied skin grafts?

Answer 7

Serum imbibition

Question 8

Liquid nitrogen cryotherapy is commonly used to treat skin tumors. What is the boiling point of liquid nitrogen?

Answer 8

-320.4*C

Question 9

T/F: Third and fourth degree burns tend to be less painful than first or superficial second degree burns

Answer 9

True

Question 10

T/F: Deep second degree burns heal without complication or grafting because the germinal layer is spared

Answer 10

False; Deep second degree wounds involve all layers, including the basal layers (only germinal cells in hair follicles and sweat glands) and result in extensive scarring unless grafted.

Question 11

T/F: In areas affected by third degree burns that are allowed to heal without grafting, there is a lack of hair and sweat glands

Answer 11

True

Question 12

First degree wounds are painful but tend to heal without complication

Answer 12

True

Question 13

Staphylococcus aureus growing within a biofilm is ____-fold more resistant to antimicrobial therapy when compared to the planktonic form.

Answer 13

100

Question 14

T/F: Isotonic saline solutions are more effective at removing bacteria and debris than tap water

Answer 14

False

Question 15

T/F: The effectiveness of wound irrigation decreases as the time since injury increases

Answer 15

True

Question 16

Chlorhexidine diacetate should be diluted to a concentration of 0.05% prior to use in wound lavage

Answer 16

True

Question 17

Povidone-iodine is safe and effective as a wound lavage at concentrations of 0.1-0.2%

Answer 17

True

Question 18

What is the recommended medium for storing split-thickness sheet grafts?

Answer 18

McCoy’s 5A medium (balanced electrolyte solution containing amino acids, vitamins, dextrose, and a pH indicator (phenol red)) *Manuka honey has also been used successfully for up to 3 weeks

Question 19

Which of the following is not cited as a cause of exuberant granulation tissue? a. excessive motion b. prolonged inflammatory phase of wound healing c. bandaging d. tissue hypoxia

Answer 19

a. excessive motion

Question 20

After approximately 48 hours after skin graft placement, new capillaries generated in the recipient bed traverse the fibrin layer to anastomose with those in the graft. What is the name of this process?

Answer 20

Inosculation

Question 21

What is Dakin’s solution?

Answer 21

Sodium hypochlorite (dilute household bleach)

Question 22

Which is not a benefitial effect of tris-ethylenediamine tetra-acetic acid (Tris-EDTA) when used for wound treatment?

a. promotes epithelialization, speeding wound healing
b. exerts an antimicrobial effect by lysing the cell membrane of bacteria
c. alkalizes the wound bed
d. potentiates the antibacterial effects of penicillins, oxytetracyclines, aminoglycosides, and fluoroquinolones

Answer 22

a.

Question 23

What is the name of the antibacterial compound found specifically in Manuka honey?

Answer 23

Methylglyoxal

Question 24

Carbon monoxide poisoning is one mechanism of inhalation injury. What is the excretion rate of carbon monoxide relative to oxygen tension when breathing 100% oxygen?

Answer 24

30 minutes

The excretion rate is 3-4 hours on room air, highlighting the need to supplement 100% oxygen immediately when evaluating barn fire victims. The excretion rate can be modestly improved (22 inutes) with hyperbaric oxygen therapy.

Question 25

The process of angiogenesis, or new blood vessel formation, is critical for providing oxygen and nutrients for the wound healing process. What conditions within the wound initiate angiogenesis?

Answer 25

Decreased oxygen tension, high lactate levels, and low wound pH

Question 26

T/F: the antiseptic polyhexamethylene biguanide (PHMB) found in antimicrobial kerlix exerts its antimicrobial effects by adhering to and disrupting target cell membranes

Answer 26

True

Question 27

T/F: wounds cleaned with the antiseptic polyhexamethylene biguanide (PHMB) found in antimicrobial kerlix heal significantly faster than wounds cleansed with isotonic saline solution or Ringer’s solution

Answer 27

True

Question 28

T/F: the antiseptic polyhexamethylene biguanide (PHMB) found in antimicrobial kerlix enhances proliferation of keratinocytes and promotes epithelialization

Answer 28

true

Question 29

T/F: the antiseptic polyhexamethylene biguanide (PHMB) found in antimicrobial kerlix demonstrates efficacy against gram-negative organisms and fungi, but not gram-positive organisms

Answer 29

False; PHMB is effective against both gram + and gram -, but may not be effective against all gram-negative organisms in one small animal study

Question 30

What is the ideal pressure for wound lavage cited in Equine Surgery?

Answer 30

6 to 12 psi;

however, Equine Wound Management cites 8-15 psi and recommends lavage with a 35 0r 60 mL syringe attached to an 18 or 19 gauge needle, but Equine Surgery warns that this combination may lead to excessive pressure generation.

Question 31

T/F: Both PMNs and macrophages function to remove necrotic cells and bacteria in wound healing

Answer 31

True

Question 32

T/F: Macrophages are the first cell to enter the wound in large numbers

Answer 32

False; PMNs arrive in the wound first

Question 33

T/F: the principal degradative proteinases released by PMNs include cathepsin G, and neutrophil-specific interstitial collagenase

Answer 33

True

Question 34

T/F: Animal models have demonstrated that neither neutrophils nor macrophages are essential to wound healing under sterile conditions

Answer 34

True

Question 35

T/F: When comparing wound healing, ponies demonstarted a quicker and more intense inflammatory reaction in response to wounding than that seen in horses

Answer 35

True

Question 36

T/F: When comparing wound healing in ponies to wound healing in horses, leukocytes from pnies produce higher levels of reactive oxygen species, IL-1, TNF, and TGH-b1

Answer 36

True

Question 37

T/F: When comparing horses and ponies, faster wound healing in ponies has been demonstrated in both body and limb wounds

Answer 37

true

Question 38

T/F: When comparing wound healing in horses and ponies, metatarsal bone involvement results in a greater periosteal reaction and new bone formation in horses than in ponies

Answer 38

True

Question 39

What is the mechanism of action of chlorhexidine (Nolvasan)?

Answer 39

Cell membrane disruption and cellular protein precipitation

Question 40

The differentiation of fibroblasts to myofibroblasts is considered by most investigators to be necessary for contraction to occur. What cytokine is considered to be the primary inducer of this differentiation?

Answer 40

TGF-b1