Exam 2: Chapter 8

Question 1

What are the extrinsic factors that affect wound healing in acute surgical wounds

Answer 1

1. preoperative period
2. intraoperative period
3. postoperative period

Question 2

What are things to consider during the preoperative period

Answer 2

The length of hospital stay prior to surgery, preparation of the operative site, and prophylactic antibiotics

Question 3

What are the different types of surgeries

Answer 3

clean
clean-contaminated
contaminated
dirty or infected

Question 4

True or false:

The longer you stay in the hospital, the higher risk you have of developing an infection

Answer 4

true

Question 5

What class of surgery is considered clean

Answer 5

class 1

Question 6

What class of surgery is considered clean-contaminated

Answer 6

class 2

Question 7

What class of surgery is considered contaminated

Answer 7

class 3

Question 8

What class of surgery is considered dirty or infected

Answer 8

class 4

Question 9

Which type of surgery is defined by nontraumatic injuries, no inflammation or break in sterile field

Answer 9

Clean or class 1

Question 10

What types of procedures are considered clean or class 1

Answer 10

Exploratory, mastectomy, THR, or vascular surgery

Question 11

What type of surgery is defined by involving the GI or respiratory tract

Answer 11

Clean-contaminated or class 2

Question 12

What types of procedures are considered clean-contaminated or class 2

Answer 12

Bronchoscopy or small bowl resection

Question 13

Which type of surgeries are defined as having a major break in sterile technique and a gross GI spillage

Answer 13

contaminated or class 3

Question 14

What types of procedures are considered to be contaminated or class 3

Answer 14

appendicitis, cholecystectomy, diverticulitis

Question 15

What types of surgeries are defined to have acute bacterial inflammation along with pus and devitalized tissue

Answer 15

dirty/infected or class 4

Question 16

What types of procedures are considered to be dirty/infected or class 4

Answer 16

drainage of abscess, perforated bowel, and peritonitis

Question 17

Who is in control during the intraoperative period

Answer 17

the surgeon

Question 18

What are factors during the intraoperative period that will affect wound healing

Answer 18

Duration of the surgery, obesity, incision tension, comorbidities, type of wound closure

Question 19

What type of wound closure is used on surgical wounds

Answer 19

primary intention with sutures and staples

Question 20

True or False:

Stress of surgery activates the parasympathetic nervous system

Answer 20

False: It activates the sympathetic nervous system

Question 21

What are things to consider during the postoperative period that will affect surgical wound healing

Answer 21

vasoconstriction, hypoxia, hypothermia, pain, hypovolemia

Question 22

What are the intrinsic factors that affect wound healing in acute surgical wounds

Answer 22

age
concurrent conditions
nutritional status
oxygenation perfusion
stress and pain

Question 23

During the assessment and management of an acute surgical wound, what should we be examining

Answer 23

the location, linear measurements, observe tissue for resurfacing, closure, exudate and palpate incision for collagen deposition and health of surrounding tissue

Question 24

What are the two types of surgical dressings

Answer 24

primary and secondary

Question 25

Describe primary dressing

Answer 25

the dressing that touches the wound

Question 26

Describe secondary dressing

Answer 26

goes over the primary dressing

Question 27

True or False: Surgical wounds go through the same healing phase as other wounds

Answer 27

true

Question 28

Surgical wounds are best evaluated using ____ since the surgery

Answer 28

time

Question 29

Postoperative days __-__ show signs of inflammation, blood exudate that changes to sanguineous, epithelia resurfaces, and exudate decreases

Answer 29

days 1-4

Question 30

Postoperative days __-__ show signs of healing ridges along entire incision, wound exudate changes to serous, exudate disappears, and suture material begins to be removed

Answer 30

Days 5-9

Question 31

Postoperative days __-__ involves the removal of remaining external suture material

Answer 31

10-14

Question 32

Postoperative days __-__ is when collagen realigns and strengthened, color of incision changes from bright pink to fading pink or silvery gray, healing ridge softens, and functional ability of scar

Answer 32

days 15 to 1-2 years

Question 33

When do I refer- Significant increase of bloody ____ exudate that changes from serosanguineous to ____ Increased exudate after day ___ ____ of healing ridge Signs of local wound infection after day __

Answer 33

``` exudate purulent 4 absence 4 ```

Question 34

When do I refer- Signs of ____ infection such as high temp, high WBC, and confusion Frank wound _____ ____ formation

Answer 34

systemic dehiscence fistula