RT Book, Section
A1 Ellison, E. Christopher
A1 Zollinger, Jr., Robert M.
A1 Pawlik, Timothy M.
A1 Vaccaro, Patrick S.
A1 Bitans, Marita
A1 Baker, Anthony S.
SR Print(0)
ID 1187824753
T1 Escharotomy
T2 Zollinger’s Atlas of Surgical Operations, 11e
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781260440850
LK accesssurgery.mhmedical.com/content.aspx?aid=1187824753
RD 2024/04/24
AB As  in  cases  of  other  forms  of  injury,  there  is  expected  development  of  soft  tissue  edema  near  burn  injuries.  However,  larger  burns  (in  excess  of  20%  total  body  surface  area),  edema  of  soft  tissue  remote  to  the  burn  commonly  develops  as  well.  If  the  edema  develops  under  normal  skin  or  skin  with  a  superficial  injury,  the  skin  will  stretch  and  allow  for  a  change  in  volume  of  the  underlying  tissue.  However,  when  the  skin  suffers  a  full-thickness  burn  (eschar),  the  desiccated  tissue  loses  its  elasticity.  The  inelasticity  of  the  overlying  burned  skin,  when  it  is  circumferential  on  an  extremity,  can  cause  these  tissue  pressures  to  exceed  normal  perfusion  pressures,  thereby  compromising  blood  flow  to  the  extremity.  On  the  trunk,  a  full-thickness  circumferential  burn  can  compromise  respiratory  mechanics,  creating  an  extrinsic  restriction  of  ventilation.  Escharotomies  are  performed  to  relieve  the  restriction  imposed  by  the  layer  of  necrotic,  inelastic  skin.