Escharotomy

Following a full-thickness burn, as the underlying tissues are rehydrated, they become constricted due to the eschar's loss of elasticity, leading to impaired circulation distal to the wound.

Full-thickness circumferential and near-circumferential skin burns result in the formation of a tough, inelastic mass of burnt tissue (eschar).

The excessive fluid causes the intracompartmental pressures to increase, resulting in collapse of the contained vascular and lymphatic structures and, hence, loss of tissue viability.

Indications for emergency escharotomy are the presence of a circumferential eschar with one of the following: Neurovascular integrity should similarly be monitored frequently and in a scheduled manner.

Capillary refilling time, Doppler signals, pulse oximetry, and sensation distal to the burned area should be checked every hour.

Subsequently, any increase in capillary refill time, decrease in Doppler signal, or change in sensation should lead to rechecking the compartment pressures.