A 16-year-old boy who sustained 45% total body surface area (20% partial thickness, 15% full thickness, 10% inhalation) flame burns was admitted to our Burn Centre on 14 June 2016, via Victoria Hospital where he received emergency treatment including escharotomy
on the right lower limb.
The granulation tissue observed for the applied light intensity and the characteristics of the lamina and when there is a presence of necrosis of innovative liquefaction approach of intensity and time of use of the lamina must be incorporated and finally should be performed in coagulation necrosis and escharotomy
For circumferential burns (degree three) or tension scar, escharotomy
was performed to prevent ischemia and necrosis of the distal or deep tissue or to correct restrictive respiratory or circulatory function.
Lapid et al., "Escharotomy
using an enzymatic debridement agent for treating experimental burn-induced compartment syndrome in an animal model," Journal of Trauma, vol.
Procedures included escharotomy
, dressing changes, application of a biosynthetic skin substitute or allograft, skin grafting or wound preparation for subsequent grafting, anaesthetic services for placement of central lines, evaluation of inhalational injury, removal of surgical clips, and wound preparation of septic or neglected burns.
Two required operative intervention, including burn debridement (case 1), split thickness skin graft (case 1), and escharotomy
was done in four patients having circumferentially upper limb burns.
In this context, while continued ventilation, sedation and fluid resuscitation with the intent of supporting the end-of-life needs of family and patient were considered by both teams to be acceptable, more invasive interventions such as external cardiac massage in the event of cardiac arrest or surgical escharotomy
in the event of abdominal compartment syndrome or burns-restricted ventilation were not deemed appropriate.
Circumferential full-thickness burns on a limb require escharotomy
to enable adequate peripheral perfusion and to prevent limb loss.
Renal failure 18 6 1 y/o M Abdominal rhabdomyosarcoma Respiratory failure 23 7 3 y/o F 70% TBSA burn s/p Escharotomy
(abdomen, chest, extremities) 19 8 8 y/o M Arthrogriposis, Septic shock, GI Obstruction, UGIB; Seizures, Respiratory failure 24 9 3 m/o M BPDSeptic Shock, MSOF 22 10 8 m/o M Caudal Regression Syndrome with Respiratory arrest due to UAO, Septic Shock, MSOF, Budd Chiari 21 Patient # Diagnosis Treatment Outcome 1 60% TBSA burn and inhalation injury, ARDS Laparotomy Died 2 GI obstruction with dysmotility Septic shock, MSOF Laparotomy Died 3 Kwashiorkor, zinc deficiency Septic Shock Abdominal tube Survived 4 BPD; NEC, Septic Shock Abdominal tube Survived 5 Neuroblastoma s/p nephrectomy.
All extremity pulses were carefully assessed and escharotomy
was performed in a significantly higher proportion of patients in the AG (34.1%, v.