The development of an effective tissue viability service.

Wound management and the prevention and treatment of pressure ulcers is recognized as a major quality issue (Department of Health (DoH), 1993). However, there remains a number of NHS trusts who operate without a formal tissue viability service (TVS) (Dealey, 1994). The aim of this article is to assist those wishing to develop such a service by describing how the authors' TVS became established and how it has developed during the subsequent 5 years (Smith, 1996). It is anticipated that this information will provide a framework for practitioners who want to develop this specialty within their own trust. Traditionally, the detection and treatment of pressure ulcers has been the role of nursing staff. However, it is now recognized that this responsibility lies with many members of the multidisciplinary team, the members of which provide the foundation of an effective TVS (Smith, 1993).