What procedure is used to relieve pressure in circumferential burns?

• A. Escharotomy to relieve pressure.
• B. Bed rest only.
• C. Antibiotic therapy alone.
• D. Hyperbaric oxygen therapy.

Answer: (A)

Circumferential burns trap swelling under a rigid eschar that acts like a tourniquet, increasing pressure inside the limb or chest and risking tissue ischemia or respiratory compromise. The correct management is an escharotomy, where incisions are made through the burned skin (eschar) to release the constriction and allow the tissue to expand. This immediate mechanical relief restores blood flow and improves ventilation when the chest wall is involved. In some cases, if deeper pressure from swollen muscle compartments persists, a fasciotomy may be needed in addition, but the first and most direct step to relieve the external pressure is an escharotomy. Other options like bed rest, antibiotics alone, or hyperbaric oxygen address different issues and do not relieve the mechanical constriction caused by the eschar.