In circumferential full-thickness limb burns, escharotomy primarily aims to relieve which issue?

• A. Pressure-induced limb ischemia due to restricted perfusion
• B. Infection of the burn wound
• C. Pain reduction
• D. Cosmetic scarring

Answer: (A)

Escharotomy targets the constrictive effect of the inelastic burned skin. When a circumferential full-thickness burn forms, the eschar cannot expand as swelling occurs, so it acts like a tourniquet that increases tissue pressure and compresses blood vessels. This reduces distal perfusion and risks limb ischemia and potential compartment syndrome. Making deliberate incisions through the eschar releases this pressure and allows the tissues to expand, restoring blood flow and preventing irreversible damage. While infection, pain, and scarring are important considerations in burn care, the immediate goal of escharotomy is to relieve pressure and reestablish circulation. If perfusion remains compromised after releasing the eschar, deeper compartment release (fasciotomy) may be needed.