Leave eschar alone

Remember how as a child your mother told you “not to pick”? As a mom myself, I think it had more to do with the fingernails-on-a-chalkboard reaction to that repetitive action and the subsequent blood than the notion that the scar was protecting the boo-boo from further damage and infection and it best be left alone.

Wound care specialists, however, know (and subsequently, related guidelines have been developed) that eschar/necrotic tissue keeps a wound covered and helps facilitate healing. Concern that eschar prohibits accurate assessment for the most part is assuaged by the realization that if no other signs of trouble are present (such as warmth, redness, and the like) that herald infection or suggest debridement is warranted, the “dead” tissue is best left undisturbed. Obviously, there are exceptions, but the rule of thumb (more accurately, the rule of foot) with regard to heel wound eschar should be: Leave it alone.

Care to debate?