eschar

This morning in comes W. Bowyer, who was my wife's Valentine, she having, at which I made good sport to myself, held her hands all the morning, that she might not see the painters that were at work in gilding my chimney-piece and pictures in my dining-room.

By and by she and I by coach with him to Westminster, by the way leaving at Tom's and my wife's father's lodgings each of them some poor Jack, and some she carried to my father Bowyer's, where she stayed while I walked in the hall, and there among others met with Sergeant Pierce, and I took him aside to drink a cup of ale, and he told me the basest thing of Mr. Montagu's and his man Eschar's going away in debt, that I am troubled and ashamed, but glad to be informed of.

He thinks he has left a thousand pounds for my Lord to pay, and that he has not laid out three thousand pounds, out of the five thousand pounds for my Lord's use, and is not able to make an account of any of the money.

My wife and I to dinner to the wardrobe, and then to talk with my lady, and so by coach, it raining hard, home, and so to do business and to bed.

And if the blockage still isn't cleared, the tissue breaks down completely.

Blisters and pustules begin to form on the surface, culminating in what we call eschar.

Eschar.

Eschar is the black hardened scab of fully necrotic dead tissue.

Once you reach the eschar stage, the damage is irreversible.

There's no going back.

Right.

But when that wound bed is covered in thick, leathery, necrotic tissue, you know, Eschar, I see nurses often try to guess the depth.

Which is clinically impossible.

Eschar makes a wound completely unstageable.

Really?

Yeah, because that necrotic tissue forms a biological barrier.

These include damage to the protective dermis increasing the risk of bacterial infection, which can then lead to sepsis.

Eschar formation, that is dead tissue, increasing pressure and restricting blood flow leading to compartment syndrome, which can then lead to necrosis.

Absorption of hydrochloric or really any acid leading to severe metabolic acidosis, which can lead to organ failure, among others.

Burns are among the most horrifying acute traumas imaginable and carry with them shockingly higher mortality rates.