The debate this issue examines some of the controversial issues surrounding the future of tissue viability. The increase in complexity of the patients we now treat is leading to the development of treatments which require new skills and will push the boundaries of the specialty. These include sharp debridement and hydrosurgery techniques, a range of new negative pressure devices and the need to improve diagnostics. Wounds UK’s clinical skills course — ‘Advanced clinical skills for tissue viability practitioners’ in Paris in April will provide a new level of tissue viability education, but how far should we go with respect to furthering our skill sets? Should we continue to push the boundaries or should we consolidate the established skills we have?