Large heaped-up mass of scar tissue developed and extending beyond the wound surface is known as?

RRB Nsg. Superintendent-20 July 2019 (Shift-1)

Medical Surgical Nursing

Easy

Appeared in: RRB Nsg. Superintendent-20 July 2019 (Shift-1)

Explanation

The question describes a scar that is a 'large heaped-up mass' and, most importantly, 'extending beyond the wound surface'.
This description perfectly matches the definition of a keloid, which is an abnormal proliferation of scar tissue that grows beyond the original boundaries of the skin injury.
Keloids result from excessive collagen deposition during the healing process.
Unlike other scar types, keloids do not regress spontaneously and can continue to enlarge over time.

Option B: Acne scars are typically atrophic (pitted or depressed) due to tissue loss from inflammatory acne. They do not form large, heaped-up masses that extend beyond the original lesion.
Option C: A hypertrophic scar is also a raised, red scar, but its key differentiating feature is that it remains confined within the boundaries of the original wound.
Option D: A contracture scar involves the tightening and shrinking of the skin, often after a significant burn. It pulls the edges of the skin together and can restrict movement of joints.

Visual 1: Comparative diagram - A side-by-side illustration of a hypertrophic scar (raised, within wound borders) and a keloid (raised, extending beyond wound borders) to clarify the key visual difference.

Clinical Relevance

Nursing practice connection: Knowing Differentiation of abnormal scar formation types based on morphology helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses play a vital role in identifying patients at risk for keloids (e.g., those with a personal or family history, or individuals of African, Asian, or Hispanic descent) and providing education on wound care and prevention.
Keloids can cause significant psychosocial distress due to their appearance, as well as physical discomfort like pruritus (itching) and pain. Holistic nursing care involves addressing both the physical and emotional impact.
What if? If the question had described a raised scar that appeared 6 weeks after surgery but remained strictly within the incision line, the correct answer would be 'Hypertrophic scar'.

How to Approach the Question

First, break down the question stem to identify the key descriptors of the scar.
The most critical phrase is 'extending beyond the wound surface'. This is the primary clue.
Other descriptors are 'large' and 'heaped-up mass'.
Next, recall the definitions of the different types of scars provided in the options.
Compare the key descriptor from the stem with the definitions. A keloid is the only scar type that characteristically grows beyond the original wound boundaries.
Differentiate this from a hypertrophic scar, which is raised but stays within the wound's borders, to confirm the correct choice.

Concept Tested & Keywords

Concept Tested: Differentiation of abnormal scar formation types based on morphology.
Stem keywords: scar tissue, heaped-up mass, extending beyond the wound surface
Lead-in keywords: known as
Negative lead-in flag: false

QCv97wwV8YNnax5B0DKpsV