Regarding pressure ulcers and eschar management, which statement is correct?

Regarding pressure ulcers and eschar management, which statement is correct?

• A. A dry, intact eschar over the heels should be debrided.
• B. A dry, intact eschar over the heels without signs of infection should be left in place.
• C. Eschar should be removed to assess infection.
• D. Eschar should be moisturized with hydrogen peroxide.

Answer: (B)

A dry, intact eschar over the heels that is noninfected is best left in place because it can act as a natural protective cover and cushion for the already vulnerable heel tissue. In the absence of signs of infection or nonviability, debridement would remove this protective barrier, increasing pain, bleeding, and the risk of new tissue injury. Management focuses on offloading pressure, protecting the area, and optimizing wound conditions and nutrition while monitoring for infection. Hydrogen peroxide is not appropriate for chronic wounds because it can damage healthy tissue and delay healing; use gentle cleansing and appropriate dressings instead. Debridement is reserved for cases where the tissue is clearly nonviable or infected, or when removing it is necessary to advance healing, not simply to “assess” infection.

A dry, intact eschar over the heels that is noninfected is best left in place because it can act as a natural protective cover and cushion for the already vulnerable heel tissue. In the absence of signs of infection or nonviability, debridement would remove this protective barrier, increasing pain, bleeding, and the risk of new tissue injury. Management focuses on offloading pressure, protecting the area, and optimizing wound conditions and nutrition while monitoring for infection.

Hydrogen peroxide is not appropriate for chronic wounds because it can damage healthy tissue and delay healing; use gentle cleansing and appropriate dressings instead. Debridement is reserved for cases where the tissue is clearly nonviable or infected, or when removing it is necessary to advance healing, not simply to “assess” infection.