Escharotomy

What is an escharotomy?

An escharotomy is a surgical procedure performed to allow greater circulation to that part of the body.

Why is it performed?

A severe injury, such as a very deep burn, can cause tissue to swell so much that blood no longer flows past the injury easily. The skin acts as a tight bandage, preventing the site of injury from expanding to accommodate the swelling, resulting in compression of the blood vessels, nerves, muscle and tissue below. This problem is often referred to as compartment syndrome.

When compartment syndrome develops it is a surgical emergency. The treatment is to cut into the skin and the tissues underneath to allow them to spread open, relieving the pressure building in the affected area.

Who performs the escharotomy?

The escharotomy will be performed by a senior member of the Burns Medical team.

Are the escharotomy lines closed afterwards?

Unlike a typical surgical incision, these incisions are not closed as the operated area requires continuous assessment and monitoring.

It is normal to be able to see the tissues and structures under the open incisions. Any open wound has a risk of infection so the area will be covered by sterile dressings and bandages.

As swelling reduces, the surgical incisions will begin to close and when the edges of the incision are close enough, the patient will return to theatre to have the wounds closed, or occasionally skin grafted.

Will there be a scar?

Escharotomies can result in abnormal scarring  that can present as thick, hypertrophic, retracting and painful scars. Scar therapists will be involved in managing the escharotomy scars from the day of the surgery to try and minimise these.