Injuries and wounds: circumferential burns: practice question

A Forensic Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Forensic Medicine · Injuries and wounds: circumferential burns

Sample item

A patient with a full-thickness circumferential burn of the forearm develops a cold, pale hand with tense swelling and absent Doppler signals. What is the immediate management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Escharotomy through the burnt skin

A rigid, inelastic eschar around a limb acts like a tourniquet as oedema develops and compromises perfusion. Escharotomy, incising the eschar longitudinally, restores flow and is done urgently. Grafting and dressings do not relieve the constriction.

Option by option

  • A. Early skin grafting after three days

    Grafting later does not treat present limb ischaemia.

  • B. Escharotomy through the burnt skin (correct)

    Correct. Escharotomy releases the constricting eschar and restores perfusion.

  • C. Elevation and oral analgesics only

    Elevation and analgesia leave the ischaemia untreated and risk loss of the limb.

  • D. Topical silver sulfadiazine alone

    Silver sulfadiazine is an antimicrobial dressing and does not relieve constriction.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is B, Escharotomy through the burnt skin. A rigid, inelastic eschar around a limb acts like a tourniquet as oedema develops and compromises perfusion.

Why is "Early skin grafting after three days" not the answer?

Grafting later does not treat present limb ischaemia.

Why is "Elevation and oral analgesics only" not the answer?

Elevation and analgesia leave the ischaemia untreated and risk loss of the limb.

Why is "Topical silver sulfadiazine alone" not the answer?

Silver sulfadiazine is an antimicrobial dressing and does not relieve constriction.

What concept does this question test?

It tests Injuries and wounds: circumferential burns in Forensic Medicine. Escharotomy, incising the eschar longitudinally, restores flow and is done urgently. Grafting and dressings do not relieve the constriction.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Injuries and wounds: circumferential burns?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.