Wound Closure and Healing Flashcards

A wound that is intentionally left open to granulate from the base is healing by which intention?

Answer: Secondary intention

Secondary intention healing occurs when a wound is left open and fills in from the base by granulation tissue formation, contraction, and re-epithelialization.

Which suture material is most appropriate for a contaminated abdominal wound requiring fascial closure?

Answer: Polydioxanone (PDS) — monofilament slowly absorbable

Monofilament slowly absorbable sutures like PDS are preferred in contaminated wounds because they provide prolonged tensile strength and their monofilament structure harbors fewer bacteria than braided sutures.

The greatest tensile strength of a wound scar compared to original tissue is approximately what percentage at full maturation?

Answer: 80%

A mature scar achieves approximately 80% of the original tissue tensile strength due to reorganization of collagen fibers, but never fully equals normal tissue.

Which phase of wound healing is characterized by fibroblast proliferation and collagen deposition?

Answer: Proliferative phase

The proliferative phase (days 4–21) is dominated by fibroblast migration and collagen synthesis, along with angiogenesis and wound contraction.

A retention (stay) suture is used in abdominal closure primarily for which purpose?

Answer: To add supplemental strength in high-risk patients prone to dehiscence

Retention sutures are large, through-and-through sutures placed to provide additional fascial support in obese, malnourished, or immunocompromised patients at high risk for wound dehiscence.

The CRNFA notes that the skin edges of a closed wound are inverted (edges pointing inward). This is best corrected by:

Answer: Everting the skin edges before tying each suture and placing a vertical mattress suture if needed

Skin edge eversion during closure and use of vertical mattress sutures ensures edges are turned outward, promoting apposition of dermis to dermis and optimal scar formation.