CBM Surgical Interventions & Grafting 3

Question 1

What is the primary purpose of performing an escharotomy in a circumferential burn?

Accepted Answer

To relieve compartment syndrome and restore distal perfusion

Answer

Escharotomy incises the inelastic eschar to relieve constriction, restoring blood flow to distal tissues and preventing compartment syndrome.

Question 2

Which donor site is most commonly used for split-thickness skin grafting in burn patients with burns to the trunk?

Accepted Answer

Anterior thigh

Answer

The anterior thigh provides a large, accessible donor area with reliable healing and is the most commonly harvested site for STSGs.

Question 3

In burn surgery, fasciotomy differs from escharotomy in that fasciotomy:

Accepted Answer

Extends through the fascia to decompress muscle compartments

Answer

Fasciotomy cuts through the deep fascia to release elevated compartment pressure within muscles, while escharotomy only incises the eschar.

Question 4

Graft 'take' failure most commonly results from which cause?

Accepted Answer

Hematoma or seroma formation under the graft

Answer

Fluid collections beneath the graft prevent direct contact with the wound bed, blocking the neovascularization needed for graft survival.

Question 5

Dermal substitutes (e.g., Integra) are applied first in a two-stage procedure because they:

Accepted Answer

Establish a neodermis before a thin autograft is placed over it

Answer

Integra's collagen matrix vascularizes over 2–3 weeks, forming a dermal layer before a thin STSG is applied as the second stage.

(CBM) Certified Burn Manager Practice Test