OSCE Wound Care and Dressings Flashcards

When assessing a wound in an OSCE, which mnemonic is commonly used to structure wound assessment documentation?

Answer: TIMES: Tissue, Infection/Inflammation, Moisture, Edge, Surrounding skin

The TIMES framework provides a structured approach to wound assessment: Tissue type, signs of Infection/Inflammation, Moisture balance, wound Edge condition, and Surrounding skin.

Which wound dressing is most appropriate for a wound with moderate-to-heavy exudate?

Answer: Alginate or foam dressing — high absorbency manages heavy exudate

Alginate and foam dressings have high absorptive capacity and are designed for moderate-to-heavy exuding wounds.

What is the correct classification for a pressure ulcer where full-thickness skin loss exposes subcutaneous fat but bone, tendon, and muscle are not visible?

Answer: Category/Stage 3 pressure ulcer

Category 3 pressure ulcers involve full-thickness skin loss with visible subcutaneous fat, but without exposed bone, tendon, or muscle.

Before applying a sterile dressing in an OSCE, what is the most critical infection-prevention step?

Answer: Performing hand hygiene and applying sterile/non-touch technique throughout the procedure

Hand hygiene (before and after) combined with an aseptic non-touch technique (ANTT) prevents wound contamination and reduces healthcare-associated infection risk.

What does 'wound debridement' mean, and why is it important for wound healing?

Answer: Removal of non-viable (necrotic/sloughy) tissue to convert a chronic wound into an acute healing environment

Debridement removes necrotic tissue, slough, bacteria, and biofilm that impede healing, creating a viable wound bed that supports the healing cascade.

Which type of wound healing is characterized by surgical closure with sutures or staples?

Answer: Primary intention (first intention)

Primary intention healing involves wound closure by direct apposition of wound edges (sutures, staples, steri-strips), resulting in minimal scarring and rapid healing.

A wound dressing that maintains a moist wound environment and is suitable for clean, shallow wounds with low exudate is:

Answer: Hydrocolloid dressing

Hydrocolloid dressings create an optimal moist wound environment, promoting autolytic debridement and epithelialisation in low-exudate wounds.

Which sign most strongly indicates wound infection rather than normal inflammation?

Answer: Increasing or spreading erythema, warmth, purulent exudate, malodour, or failure to progress after appropriate treatment

Infection is characterized by spreading erythema, pus, offensive odour, increasing pain, delayed healing, and systemic signs; these exceed expected normal inflammatory response.

What is the purpose of negative pressure wound therapy (NPWT / VAC therapy)?

Answer: To apply sub-atmospheric pressure to remove exudate, reduce oedema, stimulate granulation tissue formation, and promote wound closure

NPWT applies continuous or intermittent sub-atmospheric pressure to a wound via a sealed foam dressing and canister system, promoting healing in complex wounds.

When cleansing a wound in an OSCE, what is the recommended irrigation solution for most clean wounds?

Answer: Normal saline (0.9% sodium chloride) or potable water

Normal saline or clean tap water (potable water) is safe and effective for wound irrigation; antiseptic solutions can damage fragile healing tissue and should be used selectively.

Which of the following is the correct sequence for a wound dressing change procedure in an OSCE?

Answer: Hand hygiene → explain procedure and gain consent → prepare equipment → clean gloves to remove soiled dressing → hand hygiene → sterile gloves + ANTT to clean and apply new dressing → dispose of waste → document

The correct sequence follows ANTT principles: preparation, consent, non-sterile gloves for removal, hand hygiene between steps, sterile technique for cleaning and new dressing application.

Sloughy wound tissue appears as what colour, and what does it indicate?

Answer: Yellow or tan — moist, non-viable tissue that impedes healing and requires debridement

Slough is yellow/tan moist non-viable fibrinous tissue that needs removal via debridement to allow granulation tissue formation.

What does the 'TIME' principle in wound bed preparation stand for?

Answer: Tissue management, Inflammation/Infection control, Moisture balance, Edge (epithelial) advancement

TIME is a framework for wound bed preparation: address non-viable Tissue, control Infection/Inflammation, balance Moisture, stimulate Edge (epithelial) advancement.

A patient has a venous leg ulcer. Which dressing and compression approach is most evidence-based?

Answer: Moist wound dressings combined with multi-layer compression bandaging to address venous hypertension

Venous leg ulcers are caused by venous hypertension; evidence shows compression therapy (multi-layer bandaging) is the cornerstone of treatment, combined with appropriate wound dressings.

When documenting wound size in an OSCE, what measurements should be recorded?

Answer: Length (longest diameter), width (widest perpendicular diameter), and depth; also document undermining and sinus tracts if present

Standardized wound measurement includes length × width × depth; documenting undermining and sinus tracts provides a complete 3D picture of wound status.

Which type of debridement is most selective, only removing non-viable tissue without damaging healthy wound tissue?

Answer: Autolytic debridement (using moisture-retentive dressings to activate the body's own enzymes)

Autolytic debridement harnesses the body's endogenous proteolytic enzymes under moisture-retentive dressings to selectively liquefy non-viable tissue while leaving healthy tissue intact.

What is the significance of a wound with 'rolled/epibolic wound edges' in chronic wound assessment?

Answer: The wound edges have rolled inward, preventing epithelial cell migration across the wound surface — requiring edge debridement or biological therapies

Epibolic (rolled/callused) wound edges prevent keratinocytes from migrating across the wound bed to close it — a significant barrier to healing requiring specific intervention.

Which pressure relief intervention is most important for preventing and treating sacral pressure ulcers?

Answer: Regular repositioning (every 2 hours or per care plan), use of pressure-redistributing mattresses/overlays, and proper positioning

Regular repositioning every 2 hours reduces sustained pressure over bony prominences; pressure-redistributing surfaces (foam, gel, air mattresses) reduce peak pressures. Both are essential.

What is a 'fistula' in the context of wound care, and what is the clinical significance?

Answer: An abnormal tract connecting two epithelial-lined surfaces (e.g., gut to skin or bladder to vagina) — may produce persistent wound contamination, requiring specialist management

A fistula is an abnormal communication between two body surfaces or cavities — wound fistulae can contaminate wound beds with enteric or urinary content, severely impeding healing.

In an OSCE wound care station, a wound swab is taken. When is swabbing indicated?

Answer: When there are clinical signs of infection (increasing pain, erythema, purulent exudate, malodour, systemic signs) — not routinely for all wounds

Wound swabbing should be performed only when there are clinical signs of infection, not routinely — all wounds are colonised with bacteria and routine swabbing is not clinically useful.