8.5 Common surgical procedures for burn wound: 

First degree wounds are minor with minimal loss of barrier function, and therefore require no dressing and are treated with topical salves (an ointment) to decrease pain and keep the skin moist. Second degree wounds can be treated with daily dressing changes and topical antibiotics. Deep second degree and third degree wounds require excision and grafting for sizable burns, and the initial dressing should be aimed at holding bacterial proliferation in check until the initial operation is performed. 

• Escharotomy is releasing the burn wound eschar (a dry scab or crust formed over the burn wound) by incising the lateral and medial aspects of the extremity with a scalpel. When a deep second or third degree burn wound encompasses the circumference of an extremity, the peripheral circulation of the limb can be compromised. The generalized edema and the non yielding eschar can impede venous outflow and eventually affects arterial inflow to the distal beds. This can be diagnosed by the symptoms of increased tingling or limb pain and by checking the capillary refill. 
• Grafting and Excision: the treatment of a burn would include dressing changes and topical antimicrobial agents until the eschar separates, then the granulating wound would be covered with split-thickness skin graft . This process would often take three to five week. The patients with severe wounds would often die of sepsis, and if they survived, would have severe contractures and hypertrophic scars.