Escharotomy for the Face: Facial Aesthetic Subunit Principle-Based Approach

Escharotomy is the relaxation of an eschar through longitudinal or horizontal incisions in order to protect regional perfusion. In peripheral areas, such as limbs, trunk, and neck, eschar pressure poses significant issues; it causes circulatory disorder in limbs and potential limb loss, inadequate thoracic expansion in the thorax, and perfusion and oxygenation problems in the neck. To prevent complications, a basic rule of burn surgery is to perform escharotomy incisions quickly and without hesitation. However, the face is not an area in which eschar formation is commonly seen due to its robust vascular supply and patients' protection reflex. Although descriptive drawings and guides for facial escharotomy have yet to be published, relaxation of axial arteries in terms of compression from eschar formation may be needed. Here, we present a case of escharotomy based on facial subunit principles.