Surgical Wound infections MCQs: Bailey and Love Surgery (Chapter 5)

Surgery MCQs with Answers
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Surgical Wound infections MCQs

MCQs on Surgical Wound infections based on Bailey and Love Surgery Textbook (Chapter 5)

1. Koch’s postulates proving whether a given organism is the cause of a given disease are all except:

A.  It must be found in every case

B.  It should be possible to isolate it from the host    and grow it in culture

C. It may not reproduce the disease when injected into another healthy host

D. It should be recovered from an experimentally infected host

Answer and Explanation

Answer C

Koch”s third postulate states that the organism should reproduce the disease when injected into another healthy host.

2. The principles of antiseptic surgery were  enhanced with aseptic surgery at the turn of:

A. the twentieth century

B. the eighteenth century

C. the nineteenth century

D. the medieval era

Answer and Explanation

Answer A 
Surgical Wound infections

Louis Pasteur recognised through his germ theory that microorganisms were responsible for infecting humans and causing disease. Joseph Lister applied this knowledge to the reduction of colonising organisms in compound fractures by using antiseptics. The principles of antiseptic surgery were soon enhanced with aseptic surgery at the turn of the twentieth century. As well as killing the bacteria on the skin before surgical incision (antiseptic technique), the conditions under which the operation was performed were kept free of bacteria (aseptic technique).

3. The discovery of the antibiotic penicillin is attributed to Alexander Fleming in:

A 1924

B 1928

C 1929

D 1941

Answer and Explanation

Answer B  

The discovery of the antibiotic penicillin is attributed to Alexander Fleming in 1928, but it was not isolated for clinical use until 1941, by Florey and Chain. The first patient to receive penicillin was Police Constable Alexander in Oxford

4. According to the Lancefield A–G carbohydrate antigens classification which is the most pathogenic organism causing surgical wound infections:

A  Group A Streptococcus

B  Gama-haemolytic Streptococcus

C  Alpha-haemolytic Streptococcus viridans

D  Peptostreptococcus

Answer and Explanation

Answer A

In the Lancefield A–G carbohydrate antigens classification, it is the group A Streptococcus, also called Streptococcus pyogenes, that is the most pathogenic. It has the ability to spread, causing cellulitis, and to cause tissue destruction through the release of enzymes such as streptolysin, streptokinase and streptodornase. g-haemolytic Streptococcus and Peptostreptococcus, are anaerobes which are foumd in synergy with Lancefield group D organism  Streptococcus faecalis . 

a-haemolytic Streptococcus viridans is not associated with wound infections

5. Clostridium perfringens, which is responsible for gas gangrene, releases all the following proteases except:

A Hyaluronidase

B Lecithinase

C Haemolysin

D Oxydase

Answer and Explanation

Answer: D  

Clostridium perfringens, which is responsible for gas gangrene, releases proteases such as hyaluronidase, lecithinase and haemolysin, which allow it to spread through the tissues

6. All the following factors determine whether a wound will become infected, except:

A  Host response

B  Virulence and inoculum of infective agent

C  Vascularity and health of tissue being invaded  (including local ischaemia as well as systemic shock)

D  Presence of dead or foreign tissue

E  Absence of antibiotics during the ‘decisive period

Answer and Explanation

Answer E 

Factors that determine whether a wound will become infected
● Host response
● Virulence and inoculum of infective agent
● Vascularity and health of tissue being invaded (including local ischaemia as well as systemic shock)
● Presence of dead or foreign tissue
● Presence of antibiotics during the ‘decisive period
Surgical Wound infections

7. Which of the given options hold true for the following statement:

There is up to a  ______ interval before bacterial growth becomes established enough to cause an infection after a breach in the tissues, whether caused by trauma or surgery. This interval is called the ‘____________’.

A  6 hrs, decisive period

B  4 hrs, decisive period

C  6 hrs ,window period

D  4 hrs, window period

Answer and Explanation

Answer B 

There is up to a 4-hour interval before bacterial growth becomes established enough to cause an infection after a breach in the tissues, whether caused by trauma or surgery. This interval is called the ‘decisive period’

8. Which of the following is not included as a risk factor for increased risk of wound infection:

A  Malnutrition (obesity, weight loss)

B  Colonisation and translocation in the gastrointestinal tract

C  Poor perfusion (systemic shock or local ischaemia)

D  Poor surgical technique (dead space, haematoma)

E  All are included

Answer and Explanation

Answer E

Risk factors for increased risk of wound infection

  • Malnutrition (obesity, weight loss)
  • Metabolic disease (diabetes, uraemia, jaundice) 
  • Immunosuppression (cancer, AIDS, steroids, chemotherapy and radiotherapy)
  • Colonisation and translocation in the gastrointestinal tract
  • Poor perfusion (systemic shock or local ischaemia) 
  • Foreign body material
  • Poor surgical technique (dead space, haematoma)

9. According to the Southampton Wound Grading system which of the following is not included under its Major complication:

A Pus along wound (>2 cm)

 B Pus at one point only (≤2 cm)

 C Pus along wound (>4 cm)

 D Deep or severe wound infection with or without tissue breakdown; haematoma requiring aspiration

Answer and Explanation

Answer  C

Southampton wound grading system.

Grade Appearance

0  Normal healing

I     Normal healing with mild bruising or  erythema

Ia Some bruising

Ib Considerable bruising

Ic  Mild erythema

II   Erythema plus other signs of inflammation IIa  At one point

IIb Around sutures

IIc  Along wound

IId Around wound

III  Clear or haemoserous discharge

IIIa  At one point only (≤2 cm)

IIIb  Along wound (>2 cm)

IIIc  Large volume

IIId  Prolonged (>3 days)

Major complication

 IV Pus

 IVa At one point only (≤2 cm)

 IVb Along wound (>2 cm)

 V Deep or severe wound infection with or without tissue breakdown; haematoma requiring aspiration

10. The ASEPSIS wound score includes the following criteria except:

A  Antibiotics for wound infection  

B  Debridement of the wound under general anaesthesia

C Separation of deep tissues

D  Drainage of pus under local anaesthesia

E  Stay as inpatient shortened under 7 days as a result of wound infection

Answer and Explanation

Answer E

The ASEPSIS wound score. Criterion Points 

Additional Treatment

  • Antibiotics: 10
  • Drainage of pus under L.A: 5
  • Debridement of wound under G.A: 10

Serous Discharge: 0-5

Erythema: 0-5

Purulent Exudates: 0-10

Separation of deep tissue:   0-10

-Isolation of bacteria: 10-Stay in hospital prolonged over 14 days: 5

Bailey and Love MCQs

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