Certified Nurses Operating Room (CNOR) Practice Exam

Which condition is a contraindication for primary closure of a wound?

1. Wound edges are approximated

2. Presence of infection

3. Patient is under general anesthesia

4. Wound is clean and dry

The correct answer is: Presence of infection

The presence of infection is a significant contraindication for the primary closure of a wound. When a wound is infected, closing it can trap bacteria and pus inside, creating an environment where the infection can worsen and lead to complications such as abscess formation. Proper wound management in the presence of infection typically requires cleaning, debridement, and sometimes allowing the wound to remain open to facilitate drainage and healing. In such cases, the focus is on addressing the infection first before considering any closure options. In contrast, the other conditions mentioned do not inherently prevent primary closure. Wound edges being approximated indicates that the wound could potentially be closed, as it suggests alignment is possible. A patient under general anesthesia is not a contraindication for closure; rather, it may facilitate the procedure. A clean and dry wound is ideal for closure, as it suggests a lower risk of infection. Thus, the presence of infection stands out as the primary reason to avoid immediate closure and to manage the wound appropriately.