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The first step in local wound assessment is to evaluate the level of tissue viability present in the wound.  Viable tissue is bright red (granulating) or pink (epithelialising) and represents an environment conducive to normal wound healing.  Non-viable tissue may be black (necrotic) or yellow (sloughy) and if left in the wound, creates the ideal conditions for bacterial growth and infection. 

Identifying non-viable tissue

		A black or brownish scab on a wound indicates dead or necrotic tissue.  The scab may be soft or firm, and it may cover all the wound or just small patches of it.
		Slough comprises fibrinous material, pus and proteins.  It is often yellow in colour and may be soft or firm.

Removing necrotic tissue and slough

Cleaning the wound of dead tissue and slough is called debridement.  This can be done in many ways depending on the wound type and the experience of the clinician.  Debris and dead tissue can be removed surgically, or by using physical methods such as 'flushing' the debris out with a solution, or applying special dressings that help the body to separate the dead tissue in the wound from healthy tissue, a process called autolytic debridement.  Vascular supply should be established prior to any form of debridement.

Product solutions 

Hydrogels (Intrasite*, Solosite* Gel) and antimicrobial dressings (Iodosorb*) are two types of products that can promote the body's own ability to clean the wound of dead tissue and debris.  The Versajet* hydrosurgery system is a surgical debridement tool and should only be used by an experienced clinician.

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