Wound, Ostomy and Continence Nurses Society (WOCN) Practice Exam

What is a primary cause of refractory wounds?

1. Excessive moisture in the wound

2. Imbalance in factors regulating wound repair process

3. Improper dressing techniques

4. Inadequate nutrition

The correct answer is: Imbalance in factors regulating wound repair process

A primary cause of refractory wounds is related to the imbalance in factors regulating the wound repair process. This option is correct because wound healing is a complex physiological process that involves several interconnected factors, including the presence of growth factors, cytokines, and various cell types. When any of these factors are not optimally functioning, or when there is an overall imbalance—such as excessive inflammation or inadequate cellular response—it can lead to chronic or non-healing wounds, known as refractory wounds. Wounds may become refractory when the healing process is disrupted by underlying conditions such as diabetes, vascular insufficiency, or infections. This disruption prevents the wound from progressing through the normal phases of healing (hemostasis, inflammation, proliferation, and maturation), resulting in prolonged healing times or stagnation in the repair process. Other options, while relevant to wound management, do not directly address the core issue of healing factor imbalance. Excessive moisture, for example, can lead to maceration but is typically a contributing factor rather than a primary cause. Similarly, improper dressing techniques and inadequate nutrition are important in wound care but are often symptomatic of other underlying imbalances or may complicate the healing but do not primarily cause refractory wounds on their own. Hence, recognizing the imbalance in wound