(Continued from Part 1. This concludes the article.)
Another aspect of wounds to consider is whether or not necrotic (dead) tissue is present. Necrotic tissue is “dead” or non-viable tissue that delays the progression of healing. There are a few types you may find. Eschar is black or brown and described as hard or leathery. It firmly attaches to the wound bed and obscures the depth of the wound. Gangrene is tissue decay secondary to an interruption of blood flow to a specific area of the body. This is most seen in the distal extremities, but it can affect muscles and internal organs. Another necrotic tissue type is hyperkeratosis, more commonly known as a callus. Observed to be either white or gray, it varies in texture from firm to soggy based on the moisture level of the periwound area. If a wound is covered is obscured by a thin, stringy or mucinous, clumpy layer—this is likely slough. Slough tends to be yellow in color, moist, and loosely attached to the wound.
There is a helpful classification system used to simplify wound bed coloration. Conveniently, it is dubbed the red-yellow-black system. If the area is red/pink, protect the wound. Granulation tissue should be present, so a slightly moist environment may be most helpful. If you see yellow, slough should be removed and drainage should be absorbed. Black tissue indicates thick eschar that needs to be debrided.Continue reading“Basics of Wound Care – Part 2, by D.C.”