Why is an escharotomy performed for circumferential full-thickness chest burns?

• A. To relieve chest wall constraint and permit adequate ventilation
• B. To reduce infection risk
• C. To improve blood flow to the limb
• D. To remove necrotic tissue

Answer: (A)

The main idea is that a circumferential full-thickness burn to the chest creates a rigid eschar that acts like a tight band around the chest wall. This inelastic scar tissue restricts the chest from expanding during inspiration, raising the work of breathing and reducing tidal volumes. An escharotomy relieves this constriction by cutting through the burn eschar (and sometimes underlying fascia) to allow the chest wall to expand properly, thereby improving ventilation and oxygenation and preventing respiratory failure. It isn’t about reducing infection risk, improving blood flow to a limb, or removing necrotic tissue—that would involve other procedures such as debridement.