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

What tissue layer is most susceptible to ischemic damage?

1. Superficial skin layer

2. Subcutaneous tissue

3. Muscle/fascia layer

4. Epidermal layer

The correct answer is: Muscle/fascia layer

The muscle/fascia layer is most susceptible to ischemic damage primarily due to its high metabolic demand and reliance on a consistent blood supply. Ischemia refers to the deprivation of blood flow, which is crucial for delivering oxygen and nutrients necessary for tissue survival and function. Muscle tissue, being metabolically active, requires a significant amount of oxygen to sustain its cellular activities. In cases of reduced blood flow, whether due to compression, vascular compromise, or other factors, the muscle/fascia layer may quickly suffer damage because it cannot maintain its energy needs. Additionally, the fascia, while primarily a connective tissue, also plays an important role in protecting and supporting muscles, and it too is dependent on adequate blood supply to function properly. The other tissue layers, such as the superficial skin layer and the subcutaneous tissue, while they can be affected by ischemia, tend to be less vulnerable than the muscle/fascia layer. The epidermal layer is the outermost skin layer and is actually more resilient to brief periods of ischemia, as it is avascular (lacking blood vessels) and has a different requirement for blood flow compared to deeper layers. This context highlights why the muscle/fascia layer is the most at risk for