The morbidity associated with paediatric burn wound escharotomies

Dr Lisa Davenport1, Associate Professor Leila  Cuttle2, Dr Craig A McBride3,4, Professor  Roy Kimble2,3,4

1Townsville University Hospital, , Australia, 2Queensland University of Technology, School of Biomedical Sciences, Faculty of Health, Brisbane , Australia , 3Centre for Children’s Health Research, The University of Queensland, South Brisbane, Australia, 4Queensland Children’s Hospital, South Brisbane , Australia


An escharotomy is an effective surgical procedure for the rapid decompression of a constricting and unyielding eschar, to permit restoration of blood flow. However, an escharotomy is also a full-thickness incision, which adds additional scarring to the burn injury area. The cosmetic and functional morbidity of escharotomy scarring in children is poorly characterised.
Children who required a burn wound escharotomy at the Queensland Children’s Hospital (QCH) between May 2011 and May 2020 were included. Demographics of these children were described. In addition, the number of operations for revision of escharotomy scars were recorded as an indicator of functional or cosmetic concern.
A total of 19 patients required an escharotomy after a burn injury. Children with 1% to 96% TBSA burns required an escharotomy, with a median of 28% (IQR 10 – 39%) TBSA. Two patients (81% and 96% TBSA) died. Seventy-one percent (12/17) of survivors had operative revisions of their escharotomy scars. The median time from burn to first scar intervention was 35 weeks (IQR 19 – 70 weeks).
There is substantial morbidity associated with escharotomies in children. Further investigation of the current methods of decompression after burn injury, and the long-term morbidity of escharotomy, is required.


Lisa Davenport is a Junior doctor at Townsville University Hospital. Lisa completed her Bachelor of Medicine and Surgery at James Cook University with her honours project focused on preclinical burns research.
Since completing her degree, she has continued to pursue her research interests in burns care.

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