PMC6823097_01
(
A
) Ischemic circumferential constrictive eschar at the base of the finger (black arrow), secondary to compressive dressing, with severe vascular compromise of the finger. Arrowhead: burn lesion. (
B
) Immediate recovery of distal perfusion after emergent bilateral escharotomies (black arrow) were performed. Arrowhead: debrided burn.
10-1055-s-0039-1698403-i190473cr-1.jpg
PMC6823097_01_10-1055-s-0039-1698403-i190473cr-1.jpg
FI190473cr-1
After removal of the dressing, a circumferential constrictive eschar was observed at the base of the finger, secondary to ischemia due to the compressive dressing, which generated a significant compartment syndrome with severe vascular compromise of the finger ( Fig. 1A ). Emergent bilateral escharotomies were performed, with immediate recovery of distal perfusion ( Fig. 1B ).
Treatment of the sequelae. (
A
) Immediate postoperative result after surgical debridement of the burn on the dorsum of the finger and escharectomy of the ischemic eschar at the base and grafting with partial-thickness skin grafts. (
B
) Severe palmar contracture of the digit at 3 months follow-up. (
C
) Dorsum of hand at 8 months follow-up, after surgically releasing the contracture and grafting with full-thickness skin graft. (
D
) Palm of hand.
10-1055-s-0039-1698403-i190473cr-2.jpg
PMC6823097_01_10-1055-s-0039-1698403-i190473cr-2.jpg
FI190473cr-2
The lesions were covered with split-thickness skin grafts, the donor site being the ipsilateral arm ( Fig. 2A ). However, after 3 months, the patient presented with a palmar contracture of the digit that limited full extension of the finger ( Fig. 2B ). At 8 months follow-up, and after intense splinting and physical therapy, the patient shows a normal function, achieving complete extension of the finger, with a mature, asymptomatic, flat scar ( Fig. 2C and D ).