SELF/Skin Grafting/Cumulative Quiz

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Instructions

Work through each question carefully to choose the best answer, and submit the quiz to view your results. After completing the quiz, read through the answer explanations to review the reasoning behind both correct and incorrect options.

A 40-year old with a chronic ulcer on the shin and marginal perfusion is offered a graft. He hesitates. During consent, you explain the risks of partial graft loss and alternatives including negative pressure therapy. He asks: “If it fails, can we just try again?” Which answer best balances realism, autonomy, and surgical judgment?

	Yes, repeat grafting is usually safe; the risk is low in your situation
	Remove the first graft early to avoid repetition
	We can attempt a second graft, but we must reassess the wound bed first and manage contributing factors to reduce the same failure risk
	If the first graft fails, we generally switch to flaps rather than keep grafting

During placement of a split-thickness graft in a resource-limited theatre, you notice the graft edge is curling upward and failing to adhere in one segment. In that environment, which action is most appropriate?

	Leave the curl; it will flatten over time as healing proceeds
	Remove the entire graft and reapply a new graft from another donor site
	Add extra sutures around the curled margin without lifting the graft
	Gently lift the curled edge, irrigate the undersurface with saline, press down, and place small anchoring sutures or staples

You are selecting a dressing for a newly placed graft in a patient with moderate exudate in a rural setting. Which dressing strategy optimally balances cost, graft protection, and exudate control?

	Hydrogel sheet to hydrate graft + semi-occlusive film over top
	Silver impregnated alginate layer under an occlusive dressing
	Paraffin gauze beneath dry gauze, with moderate compression by bandage
	Dry non-adherent gauze only, replaced daily

An intraoperative bleed starts beneath the graft edge during fixation. Simultaneously, the patient's blood pressure drops. You must act quickly. Which combination of moves is most appropriate?

	Finish anchoring gently, then pack hemostatic gauze under graft edges while observing vitals
	Remove graft, secure hemostasis on bed, then reapply graft again
	Use topical hemostatic agent under the graft before full fixation, while monitoring and resuscitating the patient
	Continue fixation fully and then hike systemic pressure by fluids afterwards

After graft placement, the dressing must be changed on postoperative day 3. A trainee suggests peeling off the dressing dry to inspect. Which instruction best guides safe, realistic dressing changes in this setting?

	Wait until day 5 to reduce handling, then change and inspect
	Soak the dressing with sterile saline or fluid until slack, then gently lift edges and inspect before reapplying new layers
	Use adhesive remover or alcohol under dressing to peel off fast, then inspect quickly
	Pull edge first, lift rapidly along one side, inspect, then redress

You’re planning donor and recipient sizing for a forearm defect 4 × 6 cm. Given limited donor skin availability and risk of curling, which sizing approach is optimal?

	Harvest donor skin about 1.2× area (e.g., 4.8 × 7.2) and trim excess during placement
	Harvest donor skin almost exactly 4×6 cm to minimize donor area
	Harvest donor skin of 2× area to allow aggressive trimming
	Harvest donor slightly larger only in one dimension to permit margin overlap

A patient with borderline nutritional status undergoes grafting. Midway, you see pale graft edges and sluggish capillary refill under fresh graft. Meanwhile, the patient complains of pain. What integrated judgment is most appropriate?

	Proceed as normal — the pale edges will reperfuse over time
	Loosen dressing to relieve tension and check underlying bleeding or hematoma
	Increase analgesia to allow better blood pressure and perfusion
	Remove graft and delay further until nutrition improves

During the consent process, a patient voices fear that the donor site will scar visibly. How should you respond to both respect autonomy and maintain realistic expectations?

	Acknowledge their concern, explain typical scar outcomes, and offer donor-site alternatives if possible
	Assure them donor site scarring is usually minimal and you’ll hide it well
	State that donor site scarring is inevitable and cannot be avoided
	Minimize the donor site discussion so you don’t increase their anxiety

In a scenario where the operating theatre lacks a powered dermatome, you must decide between a Humby knife or freehand blade harvesting. Which choice, along with what precaution, best reflects module guidance and situational awareness?

	Use Humby knife with careful roller gauge calibration and limit segment length to manageable width
	Use freehand blade for speed, but take small graft strips and monitor thickness continuously
	Abandon grafting until powered equipment arrives
	Use Humby knife at maximum depth to ensure graft isn’t too thin

A mid-graft, the surgical team realizes the available skin is insufficient to cover the entire defect. Time is limited. Which integrative decision is best under resource constraints?

	Harvest graft from a different donor now even if sterile setup is suboptimal
	Use meshing or fenestration on the partial graft and stretch it to cover a bit more
	Cover the most critical functional portion first and leave remaining area to heal secondarily
	Abort grafting and return later when more skin can be harvested

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Keywords	surgery, health
SDG	SDG03 Good health and well-being
Authors	Global Surgical Training Challenge
License	CC-BY-SA-4.0
Organizations	WACS, SELF
Language	English (en)
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Created	October 7, 2025 by KatKor
Last edit	March 9, 2026 by Ian-laurel
Cite as	KatKor (2025–2026). "SELF/Skin Grafting/Cumulative Quiz". Appropedia. Retrieved June 4, 2026.
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