Authors: Hasan Gökcer Tekin, MD, Christian Kaare Paaskesen, Med. Stud, Magnus Avnstorp, MD, Bjørn Thomas Crewe, MD and Consultant wound specialist

Definition: Non-vital, dead tissue which cannot be salvaged due to devascularization.

Description:  Usually black or brown in color but can also be white. May present as dry, thick, mummified tissue (eschar) or as wet (liquefied) necrotic tissue. Dry necrosis has often a clear demarcation and a punched out appearance. Transition from dry necrosis to wet necrosis should be given special attention, as it may cause severe infections. Dry necrosis usually separates after a period from the normal wound bed due to elasticity and mechanical resistance. Fissures between the dry necrosis and underlying layers create folds where bacteria can proliferate and cause severe infection and further liquefying the necrosis (wet necrosis).

Treatment aim:  Debridement of necrotic tissue. Avoid infection during the spontaneous evolvement from dry to wet necrosis. Vascular assessment is mandatory before debridement.

Wound dressing (dry wounds): N/A (Simple gauze dressing to prevent moistening while awaiting surgical removal and reconstruction)

Wound dressing (wet wounds): N/A (Simple absorbing dressing awaiting imminent surgical treatment)

Wound exampels:

Mummified necrosis

Sacral pressure wound

Heel wound with central dry necrosis

Dry necrosis of the Achilles tendon

Dry necrosis of toes

Flap necrosis