CIRCUMFERENTIAL  BURNS,  ESCHAROTOMY,  & EXTREMITY  COMPARTMENT SYNDROME

Escharotomy is normally performed for circumferential full thickness burns.

Check pulses (preferably using a Doppler flowmeter if available). If pulse is decreased or absent:

Escharotomy incises the skin only, not the fascia and is usually sufficient for limb ischemia caused by burns unless there is underlying muscle damage, over-resuscitation, or combined injury. The requirement for escharotomy or fasciotomy usually presents in the first 48 hours following injury. If the need for either procedure has not been identified within the first 24-48 hours, then circulation is likely to remain adequate without surgical intervention.

Elevation of the burned extremities (especially the upper extremities) above the level of the heart is required to decrease edema and prevent compartment syndrome.

Escharotomy

CLINICAL INDICATIONS:

Deep partial-thickness or full-thickness circumferential burns to arms or legs.

Circumferential, full thickness burns to the chest wall.

CONTRAINIDICATIONS: No contraindications