OSCE Wound Care and Dressings 4 — Questions and Answers
Question 1: A patient has an exuding wound where the previous dressing has dried and adhered to the wound bed. The correct method to remove it is:
- Pull it off quickly to minimize pain
- Soak with normal saline until it releases freely (Correct answer)
- Cut away the adhered portion and leave the rest
- Apply alcohol to loosen the dressing
Correct answer: Soak with normal saline until it releases freely
Soaking an adherent dressing with normal saline allows atraumatic removal, preventing disruption of newly formed granulation tissue.
Question 2: Which wound measurement technique is used to determine wound volume in irregular or cavity wounds?
- Ruler measurement (length × width)
- Acetate tracing
- Wound molds or saline fill method (Correct answer)
- Photography alone
Correct answer: Wound molds or saline fill method
Volume of cavity wounds is measured by gently filling the wound with saline using a syringe, providing a quantifiable measure of wound depth and volume.
Question 3: A patient on long-term steroids has poor wound healing. The PRIMARY reason for this is:
- Steroids cause excessive bleeding
- Steroids suppress the inflammatory phase essential for healing (Correct answer)
- Steroids increase wound exudate
- Steroids cause wound infection
Correct answer: Steroids suppress the inflammatory phase essential for healing
Corticosteroids inhibit the inflammatory phase of wound healing by suppressing cytokine release and neutrophil and macrophage function.
Question 4: Silver-containing dressings are BEST indicated for:
- Clean wounds in the final stages of healing
- Infected or critically colonized wounds requiring antimicrobial action (Correct answer)
- Dry necrotic wounds
- Wounds with minimal exudate
Correct answer: Infected or critically colonized wounds requiring antimicrobial action
Silver has broad-spectrum antimicrobial properties and is indicated for infected, critically colonized, or high-risk wounds, but should be discontinued once infection resolves.
Question 5: During wound assessment, a foul odor is detected. The MOST likely cause specific to wound pathology (not dressing material) is:
- Excess granulation tissue
- Anaerobic bacterial infection or necrotic tissue breakdown (Correct answer)
- Epithelialization
- Increased fibroblast activity
Correct answer: Anaerobic bacterial infection or necrotic tissue breakdown
Foul wound odor typically indicates anaerobic bacterial colonization or infection, or necrotic tissue breakdown producing volatile fatty acids.
Question 6: A patient has a wound with 100% black eschar that is dry and intact over the heel. The recommended management is:
- Immediately debride the eschar
- Leave intact and monitor unless signs of infection develop (Correct answer)
- Apply hydrogel to soften and autolytically debride
- Pack with alginate dressing
Correct answer: Leave intact and monitor unless signs of infection develop
Dry, intact heel eschar should generally be left in place as a natural biological cover; debridement is indicated only if infection signs appear.
Question 7: What is the correct technique for measuring wound depth during assessment?
- Visual estimation from wound surface
- Insert a sterile cotton-tipped applicator perpendicular to the wound bed and measure (Correct answer)
- Use imaging only
- Measure from wound edge to opposite edge
Correct answer: Insert a sterile cotton-tipped applicator perpendicular to the wound bed and measure
A sterile cotton-tipped swab is inserted perpendicular to the deepest point of the wound bed, marked at skin level, then measured to determine wound depth.
OSCE Wound Care and Dressings 4
A patient has an exuding wound where the previous dressing has dried and adhered to the wound bed.
The correct method to remove it is: