What is a primary indication for performing an escharotomy?

A primary indication for performing an escharotomy is respiratory and circulatory compromise. This procedure is essential in cases where a patient's skin is severely burned or tight eschar has formed, which constricts underlying tissues. Such constriction can lead to impaired circulation and breathing difficulties due to reduced blood flow and limited chest wall expansion.

When eschar becomes tight, it can act like a tourniquet, especially when located on the thorax or extremities, preventing adequate blood flow to the areas beyond the constricted site. This can lead to compartment syndrome and significant complications if not addressed promptly. An escharotomy allows for the release of pressure, facilitating improved circulation and respiratory function, thereby preventing further complications associated with severe burns.

In contrast, options like the presence of large blisters or burns covering less than 10% total body surface area (TBSA) would not typically necessitate an escharotomy, as these conditions do not usually result in the critical compromise that requires such intervention. Elevation of blood pressure, while important in patient assessment, does not directly correlate with the need for this specific surgical procedure.