Escharotomy

Escharotomy is a surgical procedure used primarily to treat full-thickness burns. In this procedure, a deep incision is made into the burn eschar to relieve pressure or tension. The eschar, a piece of dead tissue, is a result of a full-thickness burn and forms a hard, tight crust on the skin surface that can hinder circulation to the underlying tissues. This can lead to complications such as compartment syndrome and ischemia.

Procedure

The escharotomy procedure is typically performed at the bedside with the patient under local anesthesia. A longitudinal incision is made through the eschar to the subcutaneous fat, effectively releasing the constricting force. The incision is usually made along the midlateral or midmedial line of the extremity, avoiding major vessels and nerves.

Indications

Escharotomy is indicated when there is circumferential full-thickness burn of an extremity or the chest, leading to impaired circulation or ventilation. Clinical signs that suggest the need for escharotomy include progressive distal cyanosis, pulselessness, paresthesia, unexplained agitation, and the inability to passively flex or extend digits.

Complications

Potential complications of escharotomy include bleeding, infection, damage to underlying structures, and inadequate release of pressure.

See also

• Burn
• Debridement
• Fasciotomy