Necrotic Tissue

Some chronic wounds may be covered with necrotic material (slough or eschar) that cannot be removed by normal cleansing or irrigation. Slough is the moist, yellowish substance composed of tissue or a mixture of fibrin and pus that contains bacteria and leukocytes. Eschar is the dry, black, leathery material that results from destruction of cells and blood vessels.

Any devitalized tissue will present a physical impediment to granulation and epithelialisation. New tissue will not be able to "burrow" under eschar to fill a wound. The necrotic material also provides an ideal medium for bacterial growth. To enhance the wound environment and healing time, it must be removed.

Debris and necrotic tissue in the wound form a barrier to delicate new tissue. The fragile new cells cannot fill in the wound if debris is present. The debris is a physical barrier as well as a potential bacterial medium. This delays healing and must be removed.

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