Fasciotomy and Escharotomy | Lecture Note

University:
High School
Course:
High School Medicine
Academic year:

2024
Views:

128

Pages:

3
Author:

customer-8484713

Fasciotomy and Escharotomy Fasciotomy vs. Escharotomy Feature Fasciotomy Escharotomy Definition A surgical incision through the fascia (connective tissue that surrounds muscle compartments) to relieve pressure. Purpose To relieve compartment syndrome caused by To relieve pressure from circumferential increased pressure within muscle compartments burns that restrict blood flow or ventilation (can lead to ischemia and necrosis). due to the inelastic eschar. Depth of Incision Deep — through skin and fascia, exposing underlying muscle. Typical Indications - Crush injuries Reperfusion injury Compartment syndrome from trauma or burns | Fullthickness circumferential burns of the chest, abdomen, or extremities Decreased distal pulses Impaired ventilation (if chest burn) | | Assessment Findings Indicating Need | - Severe, unrelenting pain Pain out of proportion to injury Paresthesia, pallor, paralysis, pulselessness (late) Compartment pressure >30 mmHg | - Circumferential burn Cool, pale, or cyanotic distal skin Absent/diminished pulses A surgical incision through the eschar (tough, leathery burned skin) to relieve constriction. Superficial — through burned skin (eschar) only, stopping before the fascia. Delayed cap refill Chest burn restricting movement/respiration | | Performed By | Surgeon (often emergent in OR or bedside) | Surgeon (often bedside or OR if extensive) | | Wound Appearance After Procedure | Open compartments with visible muscle tissue | Split, releasing tight leathery burn tissue; underlying viable tissue exposed | | Goal | Restore tissue perfusion and prevent ischemic necrosis . | Restore circulation or ventilation restricted by the eschar. | Quick Nursing Tips: Fasciotomy wounds are left open and may require negative pressure (VAC) therapy or delayed closure/grafting . Escharotomy incisions often result in immediate improvement in distal perfusion or chest wall movement. Always reassess pulses, skin color, temperature, and cap refill after the procedure to evaluate effectiveness. Both are limb-saving procedures — timely recognition of need is critical.