Thus, systems and methods providing sub-dressing wound analysis and therapy are provided. One embodiment of the invention may include a treatment system including a wound dressing comprising perforations. The system may also include a light receptor and an excitation light source. When the wound dressing is deployed on a wound, the light source may provide light that propagates through the wound and is detectable via the perforations. Furthermore, the light receptor may be configured to receive the transmitted light. The transmitted light may include information relating to the viability of tissue within the wound.