AORN Wound Management 3 — Questions and Answers
Question 1: What is the primary goal of maintaining a moist wound environment during healing?
- Preventing bacterial colonization entirely
- Facilitating cell migration and reducing scar formation (Correct answer)
- Increasing wound surface temperature
- Eliminating the need for wound dressings
Correct answer: Facilitating cell migration and reducing scar formation
A moist wound environment optimizes cell migration, supports autolytic debridement, and has been shown to reduce scar formation compared to dry healing.
Question 2: Which layer of the skin serves as the PRIMARY barrier against microbial invasion and must be carefully preserved or restored in wound management?
- Dermis
- Hypodermis
- Epidermis (Correct answer)
- Stratum granulosum
Correct answer: Epidermis
The epidermis, particularly the stratum corneum, provides the primary physical and chemical barrier against microorganisms and environmental hazards.
Question 3: A patient undergoing abdominal surgery develops a wound dehiscence on postoperative day 5. Which type of wound closure will MOST likely be used to manage this complication?
- Primary intention
- Secondary intention
- Tertiary (delayed primary) intention (Correct answer)
- Vacuum-assisted closure only
Correct answer: Tertiary (delayed primary) intention
Tertiary (delayed primary) closure allows the wound to be left open temporarily for observation and debridement before surgical closure, optimizing conditions for healing.
Question 4: When applying a sterile wound dressing intraoperatively, the perioperative nurse should ensure the dressing is applied:
- Before the surgical drapes are removed to maintain sterility (Correct answer)
- After the patient is moved to the stretcher
- After removing the surgical drapes, using clean technique
- Before the final sponge count is complete
Correct answer: Before the surgical drapes are removed to maintain sterility
Sterile dressings must be applied while the sterile field is still intact before drape removal to prevent wound contamination.
Question 5: Which phase of wound healing involves fibroblast proliferation and collagen deposition?
- Hemostasis
- Inflammatory phase
- Proliferative phase (Correct answer)
- Remodeling phase
Correct answer: Proliferative phase
During the proliferative phase, fibroblasts migrate to the wound, synthesize collagen, and form granulation tissue to fill the defect.
Question 6: Which patient factor MOST significantly impairs wound healing by reducing tissue oxygen delivery?
- Age over 65
- Tobacco smoking (Correct answer)
- Mild anemia (Hgb 10 g/dL)
- BMI of 27
Correct answer: Tobacco smoking
Tobacco smoking causes vasoconstriction and carboxyhemoglobin formation, significantly reducing tissue oxygen tension and impairing all phases of wound healing.
Question 7: In the context of perioperative wound care, what does the term 'biofilm' refer to?
- A transparent occlusive dressing used over wounds
- A structured community of bacteria encased in a protective matrix (Correct answer)
- The fibrin layer that forms during hemostasis
- A synthetic biodegradable wound closure material
Correct answer: A structured community of bacteria encased in a protective matrix
Biofilm is a complex, organized community of microorganisms embedded in a self-produced extracellular matrix that provides resistance to antimicrobials and host defenses.
AORN Wound Management 3
What is the primary goal of maintaining a moist wound environment during healing?