A client is prescribed by the physician to undergo an escharotomy. Which of the following statements made by the nurse is true regarding this procedure?
A. "It is the surgical removal of a thin layer of the client's own unburned skin."
B. "A lengthwise incision is made through the burn eschar to relieve vasodilation."
C. "It is performed at the bedside and without anesthesia."
D. "It is the application of topical enzyme agents directly to the wound, and these agents digest necrotic collagen tissue."
Correct Answer: C. “It is performed at the bedside and without anesthesia”.
An escharotomy is performed at the bedside and without anesthesia since nerve endings have been destroyed by the burn injury. An escharotomy is an emergency surgical procedure involving incising through areas of burnt skin to release the eschar and its constrictive effects, restore distal circulation, and allow adequate ventilation.
Option A: A skin graft, also known as an autograft, involves taking skin from an unburned part of the patient’s body and placing it on the wound after the burn has been removed.
Option B: Escharotomy involves making a lengthwise incision through the burn eschar to relieve vasoconstriction. The incisions should extend from unburnt skin to unburnt skin ideally, or at least into areas of more superficial burns, down to subcutaneous fat, and release any constrictions.
Option D: This is a selective method for debridement of necrotic tissue using an exogenous proteolytic enzyme, collagenase, to debride Clostridium bacteria. Collagenase digests the collagen in the necrotic tissue allowing it to detach.
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