American Board of Surgery Qualifying Exam (ABS QE) Practice Test

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A fourth-degree burn extends to which of the following layers?

Epidermis
Fat
Bone
Subcutaneous tissue

The correct answer is: Bone

A fourth-degree burn is characterized by the most severe level of tissue damage, extending through all layers of the skin and into underlying structures. This type of burn affects not only the epidermis and dermis but also involves subcutaneous tissue and can extend down to muscle, fat, and even bone. In essence, the distinction of a fourth-degree burn is that it reaches the bone or deeper, critical tissues, leading to significant loss of function and possibly requiring surgical intervention, such as skin grafting or amputations. While less severe burns may only damage the epidermis, dermis, or subcutaneous fat, fourth-degree burns represent a profound level of injury with a serious impact on healing and recovery. This deep involvement can lead to complications such as infections and may necessitate extensive medical management. Therefore, the identification of bone as potentially affected in a fourth-degree burn underscores the severity and clinical significance of this type of injury.