AORN Wound Management 2 — Questions and Answers
Question 1: When performing intraoperative wound irrigation, which solution is recommended by AORN guidelines as the primary agent for reducing surgical site infection (SSI)?
- Povidone-iodine 10%
- Normal saline (0.9%) (Correct answer)
- Hydrogen peroxide 3%
- Chlorhexidine gluconate 4%
Correct answer: Normal saline (0.9%)
AORN recommends normal saline (0.9%) as the primary irrigation solution because it is isotonic and does not damage tissue or impair healing.
Question 2: Which wound classification is assigned to a colorectal surgery case where the bowel is entered under controlled conditions with no spillage?
- Class I – Clean
- Class II – Clean-Contaminated (Correct answer)
- Class III – Contaminated
- Class IV – Dirty-Infected
Correct answer: Class II – Clean-Contaminated
Controlled entry into the GI tract without spillage is classified Class II (Clean-Contaminated), indicating a low but elevated SSI risk.
Question 3: A scrub person notices a significant increase in blood saturating wound dressings in the immediate postoperative period. What is the FIRST action the perioperative nurse should take?
- Apply additional dressing layers and document
- Notify the surgeon immediately (Correct answer)
- Remove the dressing and inspect the wound
- Administer a topical thrombin agent
Correct answer: Notify the surgeon immediately
Sudden hemorrhage may indicate a surgical complication requiring immediate surgeon assessment and possible return to the OR.
Question 4: Which type of wound closure technique uses suture placed in the subcuticular tissue to approximate skin edges without exposed suture material on the surface?
- Interrupted percutaneous suture
- Running subcuticular suture (Correct answer)
- Figure-of-eight suture
- Mattress suture
Correct answer: Running subcuticular suture
A running subcuticular (intradermal) suture is placed just below the epidermis, providing excellent cosmetic results with no surface puncture marks.
Question 5: According to AORN guidelines, at what minimum temperature should the operating room environment be maintained to support optimal wound healing and reduce SSI risk?
- 60°F (15.6°C)
- 65°F (18.3°C)
- 68°F (20°C) (Correct answer)
- 72°F (22.2°C)
Correct answer: 68°F (20°C)
AORN recommends the OR temperature be maintained at a minimum of 68°F (20°C) to support patient normothermia and reduce SSI risk.
Question 6: Which bacteria is MOST commonly associated with surgical site infections following colorectal procedures?
- Staphylococcus aureus
- Escherichia coli (Correct answer)
- Pseudomonas aeruginosa
- Clostridium difficile
Correct answer: Escherichia coli
E. coli is the predominant gram-negative organism in the colon and the most frequently isolated pathogen in colorectal SSIs.
Question 7: Negative pressure wound therapy (NPWT) promotes wound healing primarily by which mechanism?
- Delivering antibiotics directly to wound tissue
- Removing exudate and promoting granulation tissue formation (Correct answer)
- Increasing wound surface temperature to 40°C
- Preventing all microbial contact with the wound bed
Correct answer: Removing exudate and promoting granulation tissue formation
NPWT applies continuous or intermittent sub-atmospheric pressure to remove exudate, reduce edema, and stimulate granulation tissue proliferation.
AORN Wound Management 2
When performing intraoperative wound irrigation, which solution is recommended by AORN guidelines as the primary agent for reducing surgical site infection (SSI)?