BY: NANCY MORGAN, RN, BSN, MBA, WOCN, WCC, CWCMS, DWC What exactly is wound exudate?
Also known as drainage, exudate is a liquid produced by the body in response to tissue damage.
A delicate balance to keep the correct amount of fluid at the wound interface needs to be achieved.
Sanguinous exudate is fresh bleeding, seen in deep partial-thickness and full-thickness wounds.
A small amount may be normal during the inflammatory stage, but we don’t want to see blood in the wound exudate, as this may indicate trauma to the wound bed.
If you’ve recently undergone a procedure that will produce high levels of exudate during the healing process, here are some issues to look out for, as well as some great management tips: Wound discharge, when coming at a fast pace and in large volumes, can quickly soil the dressings, causing them to become overly saturated.
This can lead to smelly bandages, which can be an embarrassment for the patient.
Next we have the famous serosanguineous exudate, which is thin, watery, and pale red to pink in color.
It seems to be everyone’s favorite type of drainage to document, but unfortunately, it’s not what we want to see in a wound. So what types of drainage do you see being documented? Are you really seeing drainage that indicates trauma to the wound bed, or is the drainage type mislabeled?
Excessive wound fluid can inhibit wound healing and can lead to maceration of the peri-wound skin, further breakdown, and excoriation and skin sensitivities if inappropriately managed as it can be corrosive in nature. Wound Infection is caused by multiplying pathogenic bacteria which cause a reaction in the patient.
The use of skin barrier preparations such as LBF should be considered to protect the delicate peri-wound area. Infection can be systemic, causing the patient to become ill or local, only affecting the wound bed and surrounding tissues.
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The amount of wound drainage that a patient exudes is largely depends on the type of wound and the individual.