ABFAS Postoperative Care and Wound Management 2 — Questions and Answers
Question 1: What is the standard antibiotic prophylaxis used for clean foot and ankle surgical procedures?
- Vancomycin
- Metronidazole
- First-generation cephalosporin (cefazolin) (Correct answer)
- Ciprofloxacin
Correct answer: First-generation cephalosporin (cefazolin)
Cefazolin, a first-generation cephalosporin, is the standard prophylactic antibiotic for clean orthopedic procedures because it covers the most common skin pathogens such as Staphylococcus aureus.
Question 2: Which patient population requires the most modified wound care protocols and longer healing times after foot and ankle surgery?
- Young athletes
- Diabetic patients (Correct answer)
- Pediatric patients
- Female patients
Correct answer: Diabetic patients
Diabetic patients have impaired wound healing due to peripheral neuropathy, vasculopathy, and immune dysfunction, necessitating more intensive and modified postoperative wound care protocols.
Question 3: What is the most appropriate initial treatment for a superficial wound dehiscence after foot surgery?
- Immediate surgical re-closure
- Wet-to-dry dressing changes to promote secondary intention healing (Correct answer)
- Intravenous antibiotics alone
- Application of cyanoacrylate skin glue
Correct answer: Wet-to-dry dressing changes to promote secondary intention healing
Wet-to-dry dressing changes encourage granulation tissue formation and allow healing by secondary intention, which is the appropriate conservative first-line approach for superficial dehiscence.
Question 4: What does the RICE protocol stand for in acute postoperative foot and ankle management?
- Rest, Ice, Compression, Elevation (Correct answer)
- Range, Incision, Compression, Exercise
- Rest, Immobilization, Circulation, Evaluation
- Range, Ice, Circulation, Elevation
Correct answer: Rest, Ice, Compression, Elevation
RICE stands for Rest, Ice, Compression, and Elevation — the four key components used to manage acute postoperative pain and swelling.
Question 5: Which factor most significantly impairs postoperative wound healing in foot and ankle surgery patients?
- Patient age over 40
- Tobacco smoking (Correct answer)
- Female gender
- Vegetarian diet
Correct answer: Tobacco smoking
Tobacco smoking causes peripheral vasoconstriction and tissue hypoxia, significantly impairing wound healing and increasing the risk of infection and dehiscence.
Question 6: What does a positive Thompson test indicate in the context of postoperative foot and ankle care?
- Compartment syndrome is developing
- Achilles tendon rupture or re-rupture (Correct answer)
- Plantar fasciitis recurrence
- Metatarsal stress fracture
Correct answer: Achilles tendon rupture or re-rupture
A positive Thompson test — absence of plantar flexion when the calf is squeezed with the patient prone — confirms Achilles tendon rupture or re-rupture postoperatively.
Question 7: What is the recommended timeline for initiating formal physical therapy after total ankle replacement surgery?
- Immediately after surgery
- 1–2 weeks postoperatively
- 6–8 weeks postoperatively (Correct answer)
- 6 months postoperatively
Correct answer: 6–8 weeks postoperatively
Physical therapy for total ankle replacement typically begins at 6–8 weeks postoperatively, once wound healing is complete and early bone-implant integration has occurred.
ABFAS Postoperative Care and Wound Management 2
What is the standard antibiotic prophylaxis used for clean foot and ankle surgical procedures?