Dead dehydrated tissue, easily recognisable by a black or brownish appearance. Necrotic areas may completely cover a wound, forming a dry eschar or, alternatively, may present as small patches in the base or margins of a wound bed

• Identify the cause of the necrotic wound ie pressure or vascular disease
• Debridement of the necrotic area to allow treatment to the underlying tissue by gentle rehydration promoting natural debridement through autolysis

• Irrigate with warmed sodium chloride 0.9% to remove dressing debris
• Either a hydrogel or a hydrocolloid could be used on this wound
• If using a hydrogel remember to score the necrotic area prior to applying the gel. (If the wound is in an awkward area, you can cover the gel with paraffin gauze to keep in place.) Secondary dressing - consider a film dressing to retain moisture or a non-adherent dressing and bandage
• Sharp debridement should be considered and executed by an experienced practitioner
• If improvement of the wound is very slow, Larvae should be considered once autolysis has commenced

• When rehydrating necrotic tissue always consider protection of the surrounding tissue from maceration, ie use a barrier preparation or a hydrocolloid template.
• There are always exceptions to the rule. In people with vascular disease or diabetes, it is sometimes important not to touch these wounds as there are systemic factors to consider, ie re-vascularisation of the affected area or, in the case of diabetes, dry gangrene is often best left alone

• Good control of their diabetes
• Removal or control of the initial cause of the necrosis
• Stop smoking