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SELF/Repair of Perforations/Post Procedure Quiz

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Instructions

Work through each question carefully to choose the best answer, and submit the quiz to view your results. After completing the quiz, read through the answer explanations to review the reasoning behind both correct and incorrect options.

1

A patient with delayed presentation of a perforated duodenal ulcer undergoes repair. Tissue edges appear friable, and there was heavy initial contamination. Where should a drain be placed to support postoperative management?

Directly over the repair to ensure maximum drainage
Near the repair site without contacting the suture line
In the pelvis only, regardless of perforation location
In the subcutaneous tissue to prevent wound infection

2

After repairing a contaminated small-bowel perforation in a district hospital, the team finds that no closed-suction drains are available, but sterile tubing is on hand. Which drainage strategy best aligns with the principles described in the module?

Insert multiple passive drains into every quadrant to maximize outflow
Omit drainage entirely and rely on broad-spectrum antibiotics
Fashion a single passive drain from sterile tubing placed thoughtfully near the area of concern
Leave the abdomen without drains and plan for routine re-laparotomy

3

Following extensive lavage for a grossly contaminated perforation, the surgeon prepares for abdominal closure. Gloves and instruments have been changed, and fascial edges are robust but under some tension. Which closure plan is most appropriate?

Close fascia with strong delayed-absorbable suture (e.g., PDS) in continuous or interrupted fashion, minimizing tension; leave skin open for delayed primary closure with gauze packing
Close all layers including skin primarily with staples to seal the contamination
Use fine 3-0 rapidly absorbable sutures for fascial closure to reduce foreign body load
Close peritoneum and subcutaneous tissue while leaving fascia open under a vacuum dressing

4

On postoperative day 2, a patient develops increasing abdominal distension and persistent tachycardia. Drain output has become bilious and higher in volume than before. Which interpretation is most consistent with these findings?

Routine serous drainage from resolving contamination
Mild dehydration due to limited oral intake
Expected postoperative ileus with normal drain output changes
Possible anastomotic or repair leak requiring urgent evaluation

5

A patient is recovering after perforation repair in a small hospital with limited access to imaging and daily laboratory tests. The team is concerned about detecting sepsis or leak early. Which monitoring approach best fits this low-resource context?

Once-daily vital signs and reliance on patient-reported pain as the primary indicator
Regular vital signs, focused abdominal examination, and careful documentation of drain output and wound appearance
Primary focus on urine output and fluid charts, with abdominal examination only if fever develops
Emphasis on early mobilization and DVT prophylaxis, with abdominal review deferred until bowel sounds return


Page data
Keywords surgery, health
SDG SDG03 Good health and well-being
Authors Global Surgical Training Challenge
License CC-BY-SA-4.0
Organizations WACS, SELF
Language English (en)
Related 0 subpages, 0 pages link here
Redirects WACS Training Modules/Repair of Perforations/Post Procedure Quiz
Views 5 page views (analytics)
Created November 13, 2025 by KatKor
Last edit March 9, 2026 by Ian-laurel
Cite as KatKor (2025–2026). "SELF/Repair of Perforations/Post Procedure Quiz". Appropedia. Retrieved June 4, 2026.
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