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An eschar (/ ˈ ɛ s k ɑːr /; Greek: ἐσχάρᾱ, romanized: eskhara; Latin: eschara) is a slough [1] or piece of dead tissue that is cast off from the surface of the skin, particularly after a burn injury, but also seen in gangrene, ulcer, fungal infections, necrotizing spider bite wounds, tick bites associated with spotted fevers and exposure to cutaneous anthrax.
The incisions should be deep enough to release all restrictive effects from the eschar. The operation can be performed on the trunk, limbs, or neck, all while avoiding critical nerves, veins, and vessels. [2] Following the operation the wounds are dressed primarily with an absorbent, antimicrobial material, then wrapped lightly in a bandage.
Debridement is the medical removal of dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue. [2] [3] Removal may be surgical, mechanical, chemical, autolytic (self-digestion), or by maggot therapy.
Necrotic tissue, slough, eschar: Wounds may be covered with a layer of dead tissue which may appear cream/yellow in color (slough) or as a black, hardened tissue . Removing this tissue is critical for properly evaluating both the depth of a wound and quality of the wound bed, and promotes wound healing.
Unstageable: Full thickness tissue loss in which actual depth of the ulcer is completely obscured by slough (yellow, tan, gray, green or brown) and/or eschar (tan, brown or black) in the wound bed. Until enough slough and/or eschar is removed to expose the base of the wound, the true depth, and therefore stage, cannot be determined.
In three months, these recruits have earned the right to be called Marines. More training will come later. But there is no way, really, to prepare them for the emotional extremes of war: trauma for some, including moral injury, a violation of the sense of right and wrong that leaves a wound on the soul.
Some troops leave the battlefield injured. Others return from war with mental wounds. Yet many of the 2 million Iraq and Afghanistan veterans suffer from a condition the Defense Department refuses to acknowledge: Moral injury.
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