ASPS ASPS Wound Healing & Tissue Management 2 — Questions and Answers
Question 1: Negative pressure wound therapy (NPWT) promotes healing primarily by:
- Delivering antibiotics directly to the wound
- Removing excess fluid and promoting granulation tissue formation (Correct answer)
- Providing rigid immobilization
- Increasing wound temperature
Correct answer: Removing excess fluid and promoting granulation tissue formation
NPWT applies sub-atmospheric pressure to remove excess exudate, reduce edema, and stimulate granulation tissue through mechanical stretch.
Question 2: Which factor is MOST likely to impair wound healing in a pre-operative plastic surgery patient?
- Age under 30
- Non-smoking status
- Poorly controlled diabetes mellitus (Correct answer)
- BMI of 22
Correct answer: Poorly controlled diabetes mellitus
Hyperglycemia impairs neutrophil function, reduces collagen synthesis, and compromises angiogenesis, significantly delaying wound healing.
Question 3: A full-thickness skin graft requires a well-vascularized recipient bed primarily to:
- Prevent rejection
- Allow imbibition and inosculation for graft survival (Correct answer)
- Reduce donor site morbidity
- Prevent keloid formation
Correct answer: Allow imbibition and inosculation for graft survival
Full-thickness grafts initially survive by imbibition (passive nutrient absorption), then inosculation (vascular connection), requiring a healthy recipient bed.
Question 4: The 'delay phenomenon' in flap surgery refers to:
- Postponing surgery due to infection
- Conditioning a flap to increase its vascularity before transfer (Correct answer)
- A planned staged tissue expansion
- Delayed closure of a donor site
Correct answer: Conditioning a flap to increase its vascularity before transfer
The delay phenomenon involves partial interruption of a flap's blood supply to induce adrenergic denervation and improve perfusion before final transfer.
Question 5: Which tissue type has the LEAST capacity for regeneration after injury?
- Epithelium
- Peripheral nerve
- Cardiac muscle (Correct answer)
- Bone
Correct answer: Cardiac muscle
Cardiac muscle cells (cardiomyocytes) have extremely limited regenerative capacity and injured tissue is replaced by fibrous scar, not functional myocardium.
Question 6: In the context of tissue expansion, the process by which skin increases in surface area under chronic mechanical stretch is called:
- Creep
- Mechanical induction of mitosis (Correct answer)
- Stress relaxation
- Viscoelastic deformation
Correct answer: Mechanical induction of mitosis
Sustained mechanical stretch from a tissue expander induces mitosis in keratinocytes and fibroblasts, generating new tissue rather than just redistributing existing skin.
ASPS ASPS Wound Healing & Tissue Management 2
Negative pressure wound therapy (NPWT) promotes healing primarily by: