Current standard of care guidelines recommend that stable intact (dry, adherent, intact without erythema or fluctuance) eschar on the heels should not be removed. Blood flow in the tissue under the eschar is poor and the wound is susceptible to infection.

When should eschar be removed?

If you see that the eschar has a “wet and soupy” presentation, Dr. Reyzelman recommends immediate debridement. However, if your patient has dry black eschar that is well adhered to the underlying subcutaneous tissue, you should leave the eschar alone, according to Dr. Reyzelman.

Should all eschar be debrided?

Eschar works as a natural barrier or biological dressing by protecting the wound bed from bacteria. If the eschar becomes unstable (wet, draining, loose, boggy, edematous, red), it should be debrided according to the clinic or facility protocol.