NCWO Skin and Wound Healing 1 — Questions and Answers
Question 1: The four phases of normal wound healing in order are:
- Proliferation, hemostasis, inflammation, remodeling
- Hemostasis, inflammation, proliferation, remodeling (Correct answer)
- Inflammation, hemostasis, remodeling, proliferation
- Remodeling, proliferation, hemostasis, inflammation
Correct answer: Hemostasis, inflammation, proliferation, remodeling
Normal wound healing proceeds sequentially through hemostasis (clot formation), inflammation (immune cell recruitment), proliferation (tissue rebuilding), and remodeling (scar maturation).
Question 2: Which layer of the skin serves as the primary barrier to infection and water loss?
- Hypodermis (subcutaneous tissue)
- Dermis
- Epidermis (specifically the stratum corneum) (Correct answer)
- Muscle fascia
Correct answer: Epidermis (specifically the stratum corneum)
The stratum corneum, the outermost layer of the epidermis, forms the principal physical and biological barrier protecting against pathogens, chemicals, and transepidermal water loss.
Question 3: Collagen synthesis during wound healing is primarily the responsibility of which cell type?
- Macrophages
- Neutrophils
- Fibroblasts (Correct answer)
- Keratinocytes
Correct answer: Fibroblasts
Fibroblasts are the primary producers of collagen and extracellular matrix components during the proliferative phase, providing structural integrity to healing tissue.
Question 4: Hypertrophic scarring differs from keloid scarring in that hypertrophic scars:
- Extend beyond the original wound boundaries
- Contain no collagen
- Remain within the original wound margins and may regress over time (Correct answer)
- Only occur on the face and earlobes
Correct answer: Remain within the original wound margins and may regress over time
Hypertrophic scars are raised but confined to the original wound boundary and often improve over time, whereas keloids extend beyond wound margins and rarely resolve spontaneously.
Question 5: Factors that impair wound healing include all of the following EXCEPT:
- Diabetes mellitus with hyperglycemia
- Adequate tissue oxygenation (Correct answer)
- Malnutrition and protein deficiency
- Corticosteroid therapy
Correct answer: Adequate tissue oxygenation
Adequate tissue oxygenation promotes wound healing by supporting cellular metabolism, angiogenesis, and antimicrobial leukocyte function; all other options impair healing.
Question 6: Angiogenesis during wound healing refers to:
- The migration of epithelial cells across the wound bed
- Formation of new blood vessels from existing vasculature to support granulation tissue (Correct answer)
- Contraction of the wound margins by myofibroblasts
- Phagocytosis of bacteria by neutrophils
Correct answer: Formation of new blood vessels from existing vasculature to support granulation tissue
Angiogenesis is the process of new capillary formation from existing blood vessels, supplying the oxygen and nutrients needed for proliferating cells in the granulation tissue.
NCWO Skin and Wound Healing 1
The four phases of normal wound healing in order are: