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The Royal Marsden Hospital Manual of Clinical Nursing Procedures - Lisa Dougherty [653]

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Waldorf, H. and Fewkes, J. (1995) Wound healing. Advances in Dermatology, 10, 77–96.

Walker, J. (2007) Patient preparation for safe removal of surgical drains. Nursing Standard, 21 (49), 39–41.

Warren, M. (2008) Collaboration in developing a protocol for nurse-led seroma aspiration. British Journal of Nursing, 17 (15), 956–960.

Werdin, F., Tenenhaus, M. and Rennekampff, H.O. (2008) Chronic wound care. Lancet, 372 (9653), 1860–1862.

White, R. (2001) Managing exudate. Nursing Times, 97 (14), 59–60.

Williams, C. and Young, T. (1998) Myth and Reality in Wound Care. Quay Books, Salisbury.

Wilson, V. (2005) Assessment and management of fungating wounds: a review. British Journal of Community Nursing (Supplement), 10 (3), S28–34.

Wolcott, R.D., Kennedy, J.P. and Dowd, S.E. (2009) Regular debridement is the main tool for maintaining a healthy wound bed in most chronic wounds. Journal of Wound Care, 18 (2), 54–56.

Woodworth, P.A., McBoyle, M.F., Helmer, S.D. and Beamer, R.L. (2000) Seroma formation after breast cancer surgery: incidence and predicting factors. American Surgeon, 66 (5), 444–451.

Multiple choice questions

1 What functions should a dressing fulfil for effective wound healing?

a High humidity, insulation, gaseous exchange, absorbent.

b Anaerobic, impermeable, conformable, low humidity.

c Insulation, low humidity, sterile, high adherence.

d Absorbent, low adherence, anaerobic, high humidity.

2 When would it be beneficial to use a wound care plan?

a On all chronic wounds.

b On all infected wounds.

c On all complex wounds.

d On every wound.

3 How would you care for a patient with a necrotic wound?

a Systemic antibiotic therapy and apply a dry dressing.

b Debride and apply a hydrogel dressing.

c Debride and apply an antimicrobial dressing.

d Apply a negative pressure dressing.

4 A new, postsurgical wound is assessed by the nurse and is found to be hot, tender and swollen. How could this wound be best described?

a In the inflammation phase of healing.

b In the haemostasis phase of healing.

c In the reconstructive phase of wound healing.

d As an infected wound.

5 What are the four stages of wound healing in the order they take place?

a Proliferative phase, inflammation phase, remodelling phase, maturation phase.

b Haemostasis, inflammation phase, proliferation phase, maturation phase.

c Inflammatory phase, dynamic stage, neutrophil phase, maturation phase.

d Haemostasis, proliferation phase, inflammation phase, remodelling phase.

6 If an elderly immobile patient had a grade 3 pressure sore, what would your management be?

a Hydrocolloid dressing, pressure-relieving mattress, nutritional support.

b Dry dressing, pressure-relieving mattress, mobilization.

c Foam dressing, pressure-relieving mattress, nutritional support.

d Film dressing, mobilization, positioning, nutritional support.

Answers to the multiple choice questions can be found in Appendix 3.

These multiple choice questions are also available for you to complete online. Visit www.royalmarsdenmanual.com and select the Student Edition tab.

Appendix 1

The Code


Standards of conduct, performance and ethics for nurses and midwives

Reproduced with permission from the Nursing and Midwifery Council, London

The people in your care must be able to trust you with their health and well-being. To justify that trust, you must:

make the care of people your first concern, treating them as individuals and respecting their dignity

work with others to protect and promote the health and well-being of those in your care, their families and carers, and the wider community

provide a high standard of practice and care at all times

be open and honest, act with integrity and uphold the reputation of your profession.

As a professional, you are personally accountable for actions and omissions in your practice and must always be able to justify your decisions.

You must always act lawfully, whether those laws relate to your professional practice or personal life.

Failure to comply with this Code may bring your fitness to practise into question

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