CRNFA Wound Closure and Healing

Question 1

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

Accepted Answer

Secondary intention

Answer

Primary intention

Answer

Tertiary intention (delayed primary closure)

Answer

Quaternary intention

Question 2

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

Accepted Answer

Polydioxanone (PDS) — monofilament slowly absorbable

Answer

Silk (braided, non-absorbable)

Answer

Chromic gut (rapidly absorbable)

Answer

Polyester braided suture (Ethibond)

Question 3

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

Accepted Answer

80%

Answer

100% — fully restored

Answer

50%

Answer

25%

Question 4

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

Accepted Answer

Proliferative phase

Answer

Hemostasis phase

Answer

Inflammatory phase

Answer

Maturation/remodeling phase

Question 5

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

Accepted Answer

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

Answer

Cosmetic skin closure

Answer

To approximate subcutaneous fat only

Answer

To secure drains in place

Question 6

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

Accepted Answer

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

Answer

Adding more interrupted sutures

Answer

Applying more wound tension by pulling sutures tighter

Answer

Using staples instead of sutures