NBSTSA Wound Management & Surgical Complications 2 — Questions and Answers
Question 1: Deep vein thrombosis (DVT) prophylaxis for surgical patients most commonly includes:
- Aspirin only
- Sequential compression devices (SCDs) and/or anticoagulants (Correct answer)
- Early ambulation alone is sufficient
- Elevation of the operative extremity
Correct answer: Sequential compression devices (SCDs) and/or anticoagulants
DVT prophylaxis combines mechanical measures (SCDs) and pharmacologic agents (heparin, LMWH) based on patient risk stratification.
Question 2: Which wound closure material is most appropriate for a highly contaminated traumatic laceration?
- Staples for rapid closure
- Absorbable monofilament subcuticular suture
- Delayed primary closure with wet-to-dry dressings (Correct answer)
- Immediate closure with permanent suture
Correct answer: Delayed primary closure with wet-to-dry dressings
Highly contaminated wounds should not be closed primarily; delayed primary closure after adequate irrigation and debridement reduces infection risk.
Question 3: A retained surgical sponge identified postoperatively is an example of which category of surgical adverse event?
- Near miss
- Sentinel event (Correct answer)
- Medical error only if symptomatic
- Adverse drug event
Correct answer: Sentinel event
A retained foreign body (gossypiboma) is classified as a sentinel event by The Joint Commission — an unexpected occurrence resulting in or risking serious patient harm.
Question 4: Which suture is MOST appropriate for vascular anastomosis because of its minimal tissue reactivity and strength retention?
- Plain catgut
- Chromic catgut
- Polypropylene (Prolene) (Correct answer)
- Polyglycolic acid (Dexon)
Correct answer: Polypropylene (Prolene)
Polypropylene (Prolene) is a non-absorbable, monofilament suture with minimal tissue reactivity and permanent strength, ideal for cardiovascular anastomoses.
Question 5: Which complication occurs when blood accumulates in the tissue planes of a surgical wound?
- Seroma
- Hematoma (Correct answer)
- Abscess
- Fistula
Correct answer: Hematoma
A hematoma is a collection of blood in the wound tissue planes, often from inadequate hemostasis, that can lead to infection or dehiscence if not evacuated.
Question 6: The scrub technologist's role in the final wound count is to:
- Document the count in the operative report
- Count with the circulator and verbally confirm all counts are correct before closure (Correct answer)
- Count independently and report findings to the surgeon
- Verify instrument counts only; sponge count is the circulator's responsibility
Correct answer: Count with the circulator and verbally confirm all counts are correct before closure
The scrub person and circulator count together, both visualizing each item, and verbally confirm counts are correct to the surgeon before wound closure is completed.
NBSTSA Wound Management & Surgical Complications 2
Deep vein thrombosis (DVT) prophylaxis for surgical patients most commonly includes: