An escharotomy is a surgical procedure in which incisions are made through the eschar, the tough, inelastic layer of dead skin formed after severe burns. This procedure is primarily performed to relieve pressure caused by the tight, thickened tissue, which can restrict blood flow and impede breathing or other vital functions. It is most often required in patients with deep second- or third-degree circumferential burns that encircle a limb, chest, or other body parts, creating a constricting effect similar to a tourniquet. Without escharotomy, the compromised circulation can lead to tissue ischemia, necrosis, and even loss of limb or organ function. The main cause for an escharotomy is the buildup of pressure under the rigid eschar, which can occur rapidly after a burn injury due to swelling or fluid accumulation. It is especially urgent when the burns affect the chest, as it can interfere with respiratory function by limiting chest expansion. While escharotomy is often a necessary life-saving procedure, it carries certain risks and complications. These include infection, bleeding, and delayed wound healing. Additionally, the incisions can result in scarring or require further reconstructive surgeries. In some cases, improper or delayed performance of the procedure can lead to irreversible tissue damage. The wounds left by escharotomy may remain open and require skin grafting to fully heal. Despite the risks, timely escharotomy is crucial for preventing serious complications in burn victims and can significantly improve outcomes by restoring proper circulation and function.
