Ver el código de «Escharotomy»

==Indications==
{{Escharotomy burn indications}}

==Contraindications==
*No absolute contraindications; irreversible gangrenous limb may be futile
*Elevated IRN: not a contraindication. Give vitamin K, FFP as needed
*Skin infection: not a contraindication
*Thrombocytopenia: not a contraindication. Give platelets.

==Equipment Needed==
*Sterile prep equipment
*Scalpel in austere or ED environment without electrocautery
*Burn dressings and topical antibiotics

==Procedure==
*Baseline neurovascular exam with serial neurovasc checks with Dopplers and compartment pressures to assess for need to extend escharotomy and/or add fasciotomy
*Depth of incision controversial, may require as little as dermal release to complete subcutaneous release to fasciotomy
*Apply silver sulfadiazine dressings or antibiotics with petroleum gauze after escharotomy

===Torso===
[[File:shield incision.JPG|thumbnail]]
*Incise at ant axillary line from level of 2nd rib to 12th rib bilaterally, incising down to level of subcutaneous fat
*May have an immediate release manifested by popping sensatio
*Join these two incisions transversely

===Extremities===
[[File:feet.JPG|thumbnail]]
[[File:lower extremities.JPG|thumbnail]]
[[File:upper extremity.JPG|thumbnail]]
*Extensive escarotomies of the limbs should be carried to thenar/hypothenar eminences for UEs, and great/little toe for LEs
*Limb escharotomies are close to superficial veins, so identify if possible
*Digital escharotomies should be performed by hand surgeon if at all possible
**Restricted perfusion (focal) 
**Perform along midlateral portion of fingers/toes, extremities if no pulse by doppler
*Ankles - avoid posterior to medial malleolus due to neurovasculature
*Hands and feet - incise along dorsal interossei muscles; pay close attention to DP in feet
*Joints
**Avoid flexor surfaces of elbows, wrists and knees as shown in attached pictures
**However, it is important to release over joints due to high tension at these sites

==Complications==

==See Also==
*[[Burns]]

==External Links==

==References==
*Peck, Michael. Arizona Burn Center. Escharotomy Procedures for Burn Patients. May 26, 2015. https://www.youtube.com/watch?v=puU4aDuhc0g
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[[Category:Procedures]]