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Escharotomy in Early Burn Care

Basil A. Pruitt Jr., MC; John A. Dowling, MC; John A. Moncrief, MC
Arch Surg. 1968;96(4):502-507. doi:10.1001/archsurg.1968.01330220018003.
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IN a symposium on burns in 1951, Blocker and Moyer1 recommended escharotomy for constricting upper extremity burns. A. B. Wallace,2 in 1955, recommended multiple incisions in the eschar of the upper extremity where distal ischemia was apparent and stated that the procedure in no way jeopardized the maintenance of a subsequently dry surface. He also advocated tracheostomy in cases of severe edema of the neck with resultant pressure on the trachea. Bennett and Lewis,3 in 1958, considered the problem of operative decompression of constricting burns, stating that decompression could be accomplished either by single or multiple incisions or by immediate excision of the burn. It was their practice to incise through the length of the burn and down to the level of the deep fascia. As noted, they advocated early excision and grafting of such burns.

R. J. Meade,4 writing in 1958, emphasized that escharotomy should


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