Wound Care Certified Certification (WCC) Practice Exam

Bleeding in a wound indicates that tissue trauma has reached at least which skin layer?

1. Epidermis

2. Dermis

3. Hypodermis

4. Subcutaneous

The correct answer is: Dermis

When assessing the depth of a wound and the occurrence of bleeding, it's vital to understand the anatomy of the skin. The skin is composed of three main layers: the epidermis, dermis, and hypodermis (also referred to as subcutaneous tissue). Bleeding in a wound signifies that the protective barrier of the skin has been compromised to a level where blood vessels, primarily located within the dermis, have been damaged. The dermis is the layer of skin that contains blood vessels, nerve endings, and connective tissue. If a wound is bleeding, it indicates that the injury has penetrated through the epidermis, which is avascular and does not contain blood vessels. In contrast, the epidermis is the outermost layer, and injuries confined to this layer typically do not result in bleeding because it does not house blood vessels. The hypodermis, also known as the subcutaneous layer, lies beneath the dermis and although it is vascular and may also bleed if involved in trauma, the fundamental indicator of bleeding in a wound is the disruption of the dermis layer. Thus, recognizing bleeding as a sign of tissue trauma establishes that the injury has at least reached the dermis, which is why this is the correct response.