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Sunday, November 17, 2013

What is escharotomy, Electrical burns, high voltage burns, gangrene, treating deep circumferential 2nd degree and 3rd degree burns causing vascular compromise or reduction in blood supply to the limbs



Deep 2nd degree burns and 3rd degree burns need to be monitored and treated with great care especially if they are circumferential (burns all around the limb). This is because the burnt skin tends to constrict the limb slowly affecting the blood flow to the hand and fingers. If not treated immediately this can end up in gangrene or death of the distal part where the blood flow is limited or stopped due to the circumferential pressure. The patient shown above had deep burns of the forearm  and hand from high voltage electrical injury.This caused reduction in the blood flow to the hands and fingers.

What is escharotomy?
when blood flow to the limb is reduced from a circumferential burn, the offending eschar or deep burn tissue forming a constriction band needs to be cut open and released. If not done in the correct time the tissues will die from reduced oxygenation and blood flow and will end up in gangrene and amputation of the part. The picture above shows the escharotomy done in such a patient. The surgeon will cut open the eschar using the standard established lines of escharotomy protocols. 

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