CWCA Wound Bed Preparation 2 — Questions and Answers
Question 1: Biofilm in a chronic wound is best described as:
- A single layer of planktonic bacteria on the wound surface
- An organized bacterial community protected by a polymeric matrix (Correct answer)
- Dried exudate coating the wound perimeter
- Necrotic tissue acting as a bacterial reservoir
Correct answer: An organized bacterial community protected by a polymeric matrix
Biofilm is a structured, sessile community of bacteria encased in a self-produced extracellular polymeric matrix that confers resistance to antimicrobials and host defenses.
Question 2: Which debridement method relies on the body's own endogenous enzymes and white blood cells to liquefy necrotic tissue?
- Sharp debridement
- Mechanical debridement
- Autolytic debridement (Correct answer)
- Enzymatic debridement
Correct answer: Autolytic debridement
Autolytic debridement harnesses the body's own phagocytes and proteolytic enzymes, typically facilitated by occlusive or semi-occlusive moisture-retentive dressings.
Question 3: Healthy granulation tissue ready for wound bed closure appears as:
- Yellow and stringy with minimal vascularity
- Dark purple or maroon and friable
- Bright beefy red, moist, and granular (Correct answer)
- White and fibrous with dense collagen bundles
Correct answer: Bright beefy red, moist, and granular
Healthy granulation tissue is bright red, moist, and has a granular cobblestone appearance due to new capillary loops; it bleeds easily when touched.
Question 4: The 'I' component of the TIME framework in wound bed preparation addresses:
- Irrigation frequency and technique
- Infection and inflammation control (Correct answer)
- Intravenous antibiotic administration
- Incision site management
Correct answer: Infection and inflammation control
The 'I' in TIME stands for Infection and Inflammation control, including assessment of bacterial burden and management of prolonged or excessive inflammation that impairs healing.
Question 5: Critical colonization in a wound differs from overt infection primarily because:
- Critical colonization involves no bacteria whatsoever
- The bacterial load impairs healing without classic systemic infection signs (Correct answer)
- Critical colonization always requires systemic antibiotics
- Overt infection shows no host inflammatory response
Correct answer: The bacterial load impairs healing without classic systemic infection signs
Critical colonization represents a bacterial burden high enough to stall wound healing and cause subtle local changes (e.g., increased pain, friable tissue) without frank systemic infection signs.
Question 6: Wound irrigation pressure used during wound bed preparation should ideally fall within which range?
- 1–4 psi
- 4–15 psi (Correct answer)
- 15–25 psi
- Greater than 25 psi
Correct answer: 4–15 psi
The recommended wound irrigation pressure of 4–15 psi effectively removes surface debris and bacteria without causing tissue trauma or driving bacteria deeper into the wound.
Question 7: In wound bed preparation, the Edge of wound component focuses most directly on:
- Debridement of necrotic central tissue
- Ensuring wound margins are migrating and free from barriers to epithelialization (Correct answer)
- Controlling periwound maceration with absorbent dressings
- Measuring wound dimensions for documentation
Correct answer: Ensuring wound margins are migrating and free from barriers to epithelialization
The 'E' component assesses whether epithelial cells at the wound edge are actively migrating inward, and addresses barriers such as epibole, callus, or undermining.
CWCA Wound Bed Preparation 2
Biofilm in a chronic wound is best described as: