++
++
++
++
What determines if a scar is hypertrophic or keloid?
+
+
++
A. Amount of scar elevation
+
++
B. Borders of scar tissue extend beyond incision
+
++
+
++
++
++
Hypertrophic scars can be raised and erythematous, but do not extend beyond the borders of the incision laterally.
++
++
++
What is the most abundant collagen in the body?
+
+
++
+
++
+
++
+
++
++
++
Type I collagen is the most abundant collagen in the body.
++
++
++
Where do epithelial cells come from in wounds healing from secondary intention?
+
+
++
+
++
B. Hair follicles, sebaceous glands, and skin edges
+
++
+
++
++
++
Epithelial cells from these structures migrate out and cover the wound bed.
++
++
++
What nutritional parameter has a half-life of about 20 days?
+
+
++
+
++
+
++
+
++
D. Retinal-binding protein
++
++
Albumin has a long half-life compared to the other nutritional parameters and can give the clinician an idea of the nutritional status of patients.
++
++
++
What is the most common organism found in osteomyelitis?
+
+
++
+
++
B. Staphylococcus epidermis
+
++
C. Streptococcus pyogenes
+
++
++
++
Staphylococcus aureus is the most common pathogen in osteomyelitis; however, these infections are often polymicrobial.
++
++
++
Wounds heal best in what type of environment?
+
+
++
+
++
+
++
+
++
++
++
A moist environment is best for wound healing; however, it is imperative that wounds are not frankly wet, as this can cause stagnant fluid to form, which is a great environment for bacteria.
++
++
++
A superficial surgical site infection (SSI) is considered when?
+
+
++
A. Purulent drainage from wound
+
++
B. Occurs within 2 months from surgery
+
++
+
++
++
++
SSI has to occur within 30 days of surgery, has redness, purulence, tenderness, positive wound cultures, or is diagnosed by the attending surgeon.
++
++
++
When does chemotherapy not affect wound healing?
+
+
++
A. Chemotherapy always affects wound healing
+
++
+
++
+
++
D. 2 months after surgery
++
++
Two weeks is generally considered the safe amount of time postsurgery to perform chemotherapy, although some recommend 1 month.
++
++
++
Which nutritional factor is missing in scurvy?
+
+
++
+
++
+
++
+
++
++
++
Vitamin C is required as a cofactor for collagen hydroxylation in the synthesis of collagen.
++
++
++
Which factor(s) is/are important for management of foot ulcers in diabetic patients?
+
+
++
+
++
+
++
C. Frequent visits to a physician for inspection of feet
+
++
++
++
All of these factors are important for diabetic patients with foot ulcers. These patients often have difficulty evaluating their own feet and frequently have poor sensation secondary to their peripheral neuropathy. These things in combination can lead to an unrecognized ulcer that can blossom into a wound requiring surgical intervention and possibly amputation.