WOUND CERTIFICATION EXAM QUESTIONS AND
ANSWERS
List the principles of surgical asepsis and explain the rationale for each principle. -
answers- -sterile object remains sterile only when touched by another sterile object
-place only sterile objects on sterile field
-sterile object or field out of range of vision or an object held below a person's waist is
contaminated
-sterile object becomes contaminated by prolonged exposure to air
-a sterile object or field becomes contaminated by capillary action when a sterile surface
comes in contact w/ a wet contaminated surface
-b/c fluid flows in direction of gravity, sterile object becomes contaminated if gravity
causes a contaminated liquid to flow over surface of an object (keep wet hands up
above elbows, dry from fingers to elbows)
-the edges of a sterile field or container are contaminated (1-inch border)
Partial-thickness wound - answers- wounds that heal by primary intention and shallow
wounds that only involve loss of epidermis/dermis
Heal by resurfacing of wound with new epidermal cells
Partial-thickness wound repair - answers- inflammatory response-[erythema/edema inc
wbc to site]. Usually subsides in <24 hrs
Epidermal repair-[epidermal cells migrate across wound]. Moist env-heal in ~4days, dry
env-heal in 7 days
Dermal repair-[epidermis thickens and anchors to cells]. Resumes normal fxn. Pink, dry,
and fragile skin. Occurs concurrently w/ epidermal repair
Full-thickness wound - answers- involve tissue loss and extend to at least
Sub q layer. Can be acute (surgical wound) or chronic (pressure ulcer)
Can be healed by primary or secondary intention
Full-thickness wound repair - answers- hemostasis-[controls bleeding]. Platelets cause
coag and vasocontriction, and break down and release growth factors (gf initiate entire
, wound healing process). Does not occur in wounds healing by secondary intention!
(comprimises repair process)
Inflammation-[establish clean wound bed & bacterial balance]. Brings wbc to area,
cleans site, releases addt'l gf. Lasts 3 days in acute wounds, >3 days in chronic wound
(pressure ulcer)
Proliferation-[prod. Of new tissue, epithelialization, contraction]. W/ primary intention
new capillary networks form to provide o2 and nutrients and synthesis of collagen.
Wound contracts as collagen fibers increase in size. Epithelial cells migrate and cover
defect (occurs faster in moist env!!!!). W/ pressure ulcer, takes longer. As granulation
tissue fills defect, contraction and epithelialization can occur. Contraction is more
important in secondary wounds b/c it reduces amnt of granulation tissue needed to fill
defect!!!
Remodeling-[reorganizes collagen to produce more elastic, stronger collagen for scar
tissue]. Lasts up to 1 year. Tensile strength never more than 80% or non-damaged
tissue. Remodeling phase is same for primary and secondary intention wounds
Wound drainage=serous, sanguineous, serosanguineous, purulent. If strong
odor=infection likely
Common complications of wound healing - answers- hemorrhage
-internal or external
Demonstrate correct examination of wounds and
Wound drainage - answers- assessment
-anatomical location
-extent of tissue involvement
-size
-tissue type
-% of wound tissue
-volume and color of wound exudate
-condition of surrounding skin
Infection
-contaminated/traumatic wound infection develops within 2 to 3 days
-surgical wound infection develops within 4 to 5 days
Dehiscence
-separation above the fascia
Evisceration
-separation below the fascia and visceral organs protrude
ANSWERS
List the principles of surgical asepsis and explain the rationale for each principle. -
answers- -sterile object remains sterile only when touched by another sterile object
-place only sterile objects on sterile field
-sterile object or field out of range of vision or an object held below a person's waist is
contaminated
-sterile object becomes contaminated by prolonged exposure to air
-a sterile object or field becomes contaminated by capillary action when a sterile surface
comes in contact w/ a wet contaminated surface
-b/c fluid flows in direction of gravity, sterile object becomes contaminated if gravity
causes a contaminated liquid to flow over surface of an object (keep wet hands up
above elbows, dry from fingers to elbows)
-the edges of a sterile field or container are contaminated (1-inch border)
Partial-thickness wound - answers- wounds that heal by primary intention and shallow
wounds that only involve loss of epidermis/dermis
Heal by resurfacing of wound with new epidermal cells
Partial-thickness wound repair - answers- inflammatory response-[erythema/edema inc
wbc to site]. Usually subsides in <24 hrs
Epidermal repair-[epidermal cells migrate across wound]. Moist env-heal in ~4days, dry
env-heal in 7 days
Dermal repair-[epidermis thickens and anchors to cells]. Resumes normal fxn. Pink, dry,
and fragile skin. Occurs concurrently w/ epidermal repair
Full-thickness wound - answers- involve tissue loss and extend to at least
Sub q layer. Can be acute (surgical wound) or chronic (pressure ulcer)
Can be healed by primary or secondary intention
Full-thickness wound repair - answers- hemostasis-[controls bleeding]. Platelets cause
coag and vasocontriction, and break down and release growth factors (gf initiate entire
, wound healing process). Does not occur in wounds healing by secondary intention!
(comprimises repair process)
Inflammation-[establish clean wound bed & bacterial balance]. Brings wbc to area,
cleans site, releases addt'l gf. Lasts 3 days in acute wounds, >3 days in chronic wound
(pressure ulcer)
Proliferation-[prod. Of new tissue, epithelialization, contraction]. W/ primary intention
new capillary networks form to provide o2 and nutrients and synthesis of collagen.
Wound contracts as collagen fibers increase in size. Epithelial cells migrate and cover
defect (occurs faster in moist env!!!!). W/ pressure ulcer, takes longer. As granulation
tissue fills defect, contraction and epithelialization can occur. Contraction is more
important in secondary wounds b/c it reduces amnt of granulation tissue needed to fill
defect!!!
Remodeling-[reorganizes collagen to produce more elastic, stronger collagen for scar
tissue]. Lasts up to 1 year. Tensile strength never more than 80% or non-damaged
tissue. Remodeling phase is same for primary and secondary intention wounds
Wound drainage=serous, sanguineous, serosanguineous, purulent. If strong
odor=infection likely
Common complications of wound healing - answers- hemorrhage
-internal or external
Demonstrate correct examination of wounds and
Wound drainage - answers- assessment
-anatomical location
-extent of tissue involvement
-size
-tissue type
-% of wound tissue
-volume and color of wound exudate
-condition of surrounding skin
Infection
-contaminated/traumatic wound infection develops within 2 to 3 days
-surgical wound infection develops within 4 to 5 days
Dehiscence
-separation above the fascia
Evisceration
-separation below the fascia and visceral organs protrude
