CWS Wound Care 4 — Questions and Answers
Question 1: Which organism is MOST commonly associated with biofilm formation in chronic wounds?
- Streptococcus pyogenes
- Staphylococcus aureus (Correct answer)
- Clostridium perfringens
- Pseudomonas aeruginosa
Correct answer: Staphylococcus aureus
Staphylococcus aureus is the most frequently identified organism in chronic wound biofilms, contributing to persistent inflammation and healing failure.
Question 2: What is the PRIMARY mechanism of action of hyperbaric oxygen therapy (HBOT) in wound healing?
- Directly kills anaerobic bacteria through pressure
- Increases tissue oxygen tension to stimulate angiogenesis and immune function (Correct answer)
- Reduces wound edema through hyperosmotic effect
- Accelerates collagen breakdown to remove necrotic tissue
Correct answer: Increases tissue oxygen tension to stimulate angiogenesis and immune function
HBOT delivers 100% oxygen at increased atmospheric pressure, dramatically raising tissue pO2, which stimulates angiogenesis, enhances leukocyte bactericidal activity, and promotes collagen synthesis.
Question 3: A patient with a sacral pressure injury has black, hard, dry eschar with no fluctuance or drainage. Per NPUAP guidelines, what is the MOST appropriate initial management?
- Sharp debridement immediately
- Enzymatic debridement with collagenase
- Leave intact and monitor unless signs of infection develop (Correct answer)
- Apply wet-to-dry dressings daily
Correct answer: Leave intact and monitor unless signs of infection develop
Stable, dry eschar on heels and in some sacral locations can serve as a protective biological cover and should not be debrided unless infection signs appear.
Question 4: Which nutritional marker BEST reflects a patient's acute protein status over the previous 2–3 days?
- Albumin
- Prealbumin (transthyretin) (Correct answer)
- Transferrin
- Total lymphocyte count
Correct answer: Prealbumin (transthyretin)
Prealbumin has a half-life of 2–3 days, making it the most sensitive short-term indicator of acute protein nutritional status compared to albumin's 20-day half-life.
Question 5: In the context of venous insufficiency wounds, the term 'lipodermatosclerosis' refers to:
- Fatty deposition in wound eschar
- Chronic skin and subcutaneous tissue fibrosis from venous hypertension (Correct answer)
- Lipid-rich exudate characteristic of lymphedema
- Necrotic fat visible in deep wound beds
Correct answer: Chronic skin and subcutaneous tissue fibrosis from venous hypertension
Lipodermatosclerosis is fibrosis and induration of the skin and subcutaneous tissue caused by chronic venous hypertension, often presenting with an inverted champagne bottle appearance.
Question 6: Which cell type is PRIMARILY responsible for wound contraction during the proliferative phase?
- Macrophages
- Neutrophils
- Myofibroblasts (Correct answer)
- Mast cells
Correct answer: Myofibroblasts
Myofibroblasts, which have contractile properties, are the primary cells driving wound contraction by pulling wound edges together during the proliferative phase.
Question 7: A patient has a fistula connecting the bowel to the skin surface. Which type of wound management system is MOST appropriate?
- Standard foam dressing
- Pouching system with skin barrier wafer (Correct answer)
- Hydrocolloid dressing changed daily
- Negative pressure wound therapy without modification
Correct answer: Pouching system with skin barrier wafer
Enterocutaneous fistulas produce enzymatic, high-volume output requiring a pouching system with a skin barrier wafer to protect periwound skin and accurately measure output.
CWS Wound Care 4
Which organism is MOST commonly associated with biofilm formation in chronic wounds?