Eschars

Eschars is the plural form of eschar, a term used in medicine to describe a dry, dark, adherent crust of necrotic tissue that forms on the skin or mucous membranes after injury. Eschars are typically leathery in texture and may be black, brown, or yellow-brown in color. They represent areas where tissue death has occurred and vascular supply is compromised.

Eschars arise in a variety of settings, most commonly after thermal burns, chemical or electrical injuries, frostbite, and severe pressure ulcers. They can also occur with necrotizing soft tissue infections or after surgical wounds where tissue viability is compromised. The exact appearance and thickness of an eschar depend on the depth and nature of the underlying injury.

Pathophysiologically, eschars consist of coagulated and dead tissue with little or no perfusion. They can obscure the assessment of underlying tissue viability and may become infected, potentially delaying healing. In some burn injuries, circumferential eschars can restrict swelling and blood flow, sometimes necessitating surgical intervention such as an escharotomy.

Management typically involves careful monitoring and assessment by clinicians. Debridement to remove devitalized tissue is often required to promote healing and reduce infection risk, followed by appropriate wound care or grafting when indicated. The prognosis of injuries with eschars depends on the extent of tissue necrosis, the presence of infection, and the effectiveness of subsequent treatment.

See also: Escharotomy, debridement, necrosis.