CBM Surgical Interventions & Grafting 2 — Questions and Answers
Question 1: Which graft type carries the LOWEST risk of disease transmission in burn patients?
- Allograft
- Xenograft
- Autograft (Correct answer)
- Amnion graft
Correct answer: Autograft
Autografts use the patient's own skin, eliminating the risk of immune rejection or pathogen transmission.
Question 2: During tangential excision, the surgeon removes burned tissue until what endpoint is reached?
- Bone is exposed
- Punctate bleeding from viable tissue is observed (Correct answer)
- Fat is completely removed
- Nerve endings are visible
Correct answer: Punctate bleeding from viable tissue is observed
Punctate bleeding indicates viable, well-perfused tissue that can support a skin graft.
Question 3: A meshed split-thickness skin graft (STSG) with a 3:1 ratio is used primarily to:
- Improve cosmetic appearance
- Cover a larger wound area with limited donor skin (Correct answer)
- Increase graft thickness
- Reduce pain at the recipient site
Correct answer: Cover a larger wound area with limited donor skin
Meshing expands the graft to cover larger areas, which is especially important when donor sites are scarce in extensive burns.
Question 4: Cultured epithelial autograft (CEA) is BEST indicated when:
- Burns cover less than 20% TBSA
- Donor sites are extremely limited in massive burns (Correct answer)
- The patient is immunocompromised
- A thick dermis is required for joint coverage
Correct answer: Donor sites are extremely limited in massive burns
CEA is reserved for massive burns where insufficient donor skin exists, as it takes 2–3 weeks to culture.
Question 5: Which dressing applied over a newly placed skin graft helps prevent shear and promotes adherence?
- Wet saline gauze
- Tie-over bolster dressing (Correct answer)
- Silver sulfadiazine cream
- Hydrocolloid sheet
Correct answer: Tie-over bolster dressing
A tie-over bolster dressing immobilizes the graft against the wound bed, preventing movement that could disrupt vascularization.
Question 6: Early excision and grafting in major burns (within 48–72 hours) is associated with:
- Increased blood loss and worse outcomes
- Reduced infection rates and improved survival (Correct answer)
- Higher rates of graft failure
- Prolonged ICU stay
Correct answer: Reduced infection rates and improved survival
Early excision removes the burn eschar, reducing the bacterial load and systemic inflammatory response, improving survival.
Question 7: A full-thickness skin graft (FTSG) is preferred over STSG for which burn location?
- Trunk
- Thigh
- Face and hands (functional/cosmetic areas) (Correct answer)
- Back
Correct answer: Face and hands (functional/cosmetic areas)
FTSGs provide better cosmetic results and less contracture, making them ideal for the face and hands despite limited donor availability.
CBM Surgical Interventions & Grafting 2
Which graft type carries the LOWEST risk of disease transmission in burn patients?