National Physical Therapy Examination (NPTE) Practice Exam

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A wound is observed to have necrotic tissue with firm, crusted tissue firmly attached to the wound base. It is black and firmly adherent. What would be the most appropriate terminology to describe this?

Granulation tissue
Slough
Eschar
Nonviable

The correct answer is: Eschar

The appropriate terminology to describe this type of tissue is eschar. Eschar refers specifically to dead or necrotic tissue that appears black, is firmly attached to the wound bed, and has a dry crusty appearance. It is often the result of tissue damage due to factors such as pressure, ischemia, or infection. The firmness and adherence to the wound base are important characteristics that help in identifying it as eschar. Granulation tissue denotes healing tissue that is red, moist, and vascularized, representing an active healing process, which does not apply in this case given the description of firm and crusted black tissue. Slough refers to a yellow or gray necrotic tissue that is moist and can be more easily removed, differing from the dry, firmly adherent characteristics of eschar. Nonviable is a broader term indicating any tissue that is not alive, but it does not specifically capture the distinct features associated with eschar present in the wound described.