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Escharotomy

Escharotomy done in a patient with 3rd degree burns in his chest area. Circumferential, full-thickness burns, whether on limbs or trunk can produce a splinting or tourniquet effect which compromises circulation and reduces muscle movement, resulting in limited respiratory function. This is due to the inflexibility of the damaged tissue, which is the eschar that is formed. If untreated, this can result in distal ischemia, compartment syndrome, respiratory failure, tissue necrosis, or death. Escharotomy is an emergency surgical procedure involving incising through areas of burnt skin to release the eschar and its constrictive effects, restore distal circulation, and allow adequate ventilation. Unlike fasciotomies, where incisions are made specifically to decompress tissue compartments, escharotomy incisions do not breach the deep fascial layer.