Introduction
Escharotomy is the relaxation of the eschar through longitudinal or horizontal incisions in order to protect the deep perfusion. The pressure that it will create in the peripheral areas such as hard eschar limb, trunk, and neck causes the circulatory disorder in the limb and the risk of limb loss, inadequate thoracic expansion in the thorax and vital perfusion and oxygenation problems in the neck. It is one of the most basic rules of burn surgery to perform the determined escharotomy incisions very quickly and without hesitation to prevent complications. On the other hand, the face is not an area in which eschar formation commonly seen because of its robust vascular supply and protection reflex of the patients. Although descriptive drawings and guides for facial escharotomy has not been published yet, relaxation of axial arteries in terms of compression due to eschar formation may be needed. In this report, a case of facial subunit principles based escharotomy is presented.
Case Report
42 year old man felt into hot sand after having a vertigo attack while working close to iron processing zinc leaded high blast furnace in an iron and steel factory. Sand which was used for isolation of the ground was placed 10 meters down the furnace and patient stayed approximately half minute in a prone position on the hot sand. Patient transferred to our burn unit for corresponding 35% of the total body surface burns on the face, total scalp, neck, anterior thorax and bilateral upper extremities although he had worn protective equipment. There was no capillary fill in the facial skin. Doppler ultrasound examination showed bilateral weak facial artery, temporal superficial artery, supraorbital and trochlear artery flow. A decision was made to perform escharotomy to relieve arterial traces at 10th hour of the injury. Bilateral nasolabial, infraorbital rim, superior glabellar, temporal incisions were performed from eschar to subcutaneous fat layer in accordance with aesthetic subunits.
Conclusions
Facial escharotomy based on aesthetic subunit principles may affect the outcome by releasing axial arteries of the face. This maneuver may increase the amount of tissue to survive by releasing diminished circulation of the skin. Escharotomy of the face can help rapid edema relief and be a guide for skin grafting without incision related excessive scarring.

**Introduction**
Escharotomy is the relaxation of the eschar through longitudinal or horizontal incisions in order to protect the deep perfusion. The pressure that it will create in the peripheral areas such as hard eschar limb, trunk, and neck causes the circulatory disorder in the limb and the risk of limb loss, inadequate thoracic expansion in the thorax and vital perfusion and oxygenation problems in the neck. It is one of the most basic rules of burn surgery to perform the determined escharotomy incisions very quickly and without hesitation to prevent complications. On the other hand, the face is not an area in which eschar formation commonly seen because of its robust vascular supply and protection reflex of the patients. Although descriptive drawings and guides for facial escharotomy has not been published yet, relaxation of axial arteries in terms of compression due to eschar formation may be needed. In this report, a case of facial subunit principles based escharotomy is presented.
**Case Report**
42 year old man felt into hot sand after having a vertigo attack while working close to iron processing zinc leaded high blast furnace in an iron and steel factory. Sand which was used for isolation of the ground was placed 10 meters down the furnace and patient stayed approximately half minute in a prone position on the hot sand. Patient transferred to our burn unit for corresponding 35% of the total body surface burns on the face, total scalp, neck, anterior thorax and bilateral upper extremities although he had worn protective equipment. There was no capillary fill in the facial skin. Doppler ultrasound examination showed bilateral weak facial artery, temporal superficial artery, supraorbital and trochlear artery flow. A decision was made to perform escharotomy to relieve arterial traces at 10th hour of the injury. Bilateral nasolabial, infraorbital rim, superior glabellar, temporal incisions were performed from eschar to subcutaneous fat layer in accordance with aesthetic subunits.
**Conclusions**
Facial escharotomy based on aesthetic subunit principles may affect the outcome by releasing axial arteries of the face. This maneuver may increase the amount of tissue to survive by releasing diminished circulation of the skin. Escharotomy of the face can help rapid edema relief and be a guide for skin grafting without incision related excessive scarring.

P.107 Escharotomy for the face: Facial aesthetic subunit principle-based approach

Dear friends and colleagues,

We will be pleased to welcome you in Turin (Italy) for the 19th European Burns Association´s Congress in 2022. Italy is honored to hold the meeting of the European Burns Association for the second time, after Verona in 1995. Turin is easily reachable from everywhere in Europe, either travelling by car, train or choosing flight connections. During the meeting, held in the renewed industrial center of the main Italian historical automotive factory (i.e. Lingotto-FIAT), we will meet international burn specialists, focusing on standards of care, progresses in burn treatment, strategies to face disaster situations, with a special attention to education of younger colleagues. However, in your spare time, you might enjoy the sweet days of Italian late summer, simply wandering in the green parks and gardens along the two rivers which cross the city, or you might decide to discover the numerous art galleries, churches, palaces, libraries, walking across elegant squares and large boulevards, passing through centuries of art and history; finally, you may choose to immerse yourself in some of the most exciting museum experiences, such as the Cinema Museum and the Turin’s Egyptian museum.

Looking forward to seeing you all in Turin for the 19th European Association´s Congress in 2022!
Maurizio Stella, Congress President, Turin Burn Centre