Wound Exudate

Matthew Regulski, DPM, FFPM RCPS(Glasgow), ABMSP, FASPM, discusses what dressings he uses in his practice to control different levels of exudate.

Effective wound management often requires attending to multiple aspects of the wound itself, including properly preparing the wound bed and managing moisture and exudate, among other facets of wound care. Tissue viability is another crucial aspect of wound management. Unfortunately, many types of wounds, including acute and chronic wounds, contain devitalized tissue.

Devitalized tissue inhibits healing in multiple ways. It can serve as a source of nutrients for bacteria, especially if the tissue is necrotic. Devitalized tissue also acts as a physical barrier for re-epithelialization, thereby preventing topical compounds from penetrating the wound bed when required. Further, this tissue can prevent angiogenesis, granulation tissue formation, epidermal resurfacing, and standard extracellular matrix (ECM) formation. It can also cover the wound and render it difficult for clinicians to assess the extent and severity of the wound adequately.

As health care professionals monitor the wound drainage of a patient, it is critical to be able to recognize the different types of wound drainage. Open wounds and incision wounds may both present varying types of exudate, some of which are perfectly healthy and others that can signal an infection or slow healing. Identifying wounds that need a change in care can speed the healing process. Here are the four main types of wound drainage health care professionals need to know:

When assessing and documenting a wound, it is important to note the amount and type of wound exudate (drainage). Using our senses is a large part of the initial wound assessment, followed by accurate documentation. Wound exudate or drainage gives us significant information about what is going on with the wound, all the way down to a cellular level, and it is one of the wound components that guide our topical treatments. As mentioned in prior blogs, a dry cell is a dead cell, but a wound with too much moisture will also have delayed healing. Additionally, infection, poor nutrition, impaired mobility, impaired sensory perception, and even malignancy in the wound can impair the healing process.
In acute wounds, drainage typically decreases over several days while the wound heals, whereas in chronic wounds, a large amount of drainage is suggestive of prolonged inflammation with failure to move into the proliferative phase of wound healing. An increase in drainage with malodor can be an indication of infection and should be treated appropriately based on the overall picture and goals of wound care.
There are many different types, consistencies, colors, and characteristics of wound drainage. In this blog, we discuss the most common types and what they could mean.

By Holly Hovan MSN, GERO-BC, APRN, CWOCN-AP

We have all heard the saying: a dry cell is a dead cell… we know that a moist wound bed is most conducive to healing. If a wound is too dry, we add moisture… and if a wound is too wet, we try to absorb the drainage. There must be a balance of moist and dry to promote an optimal healing environment. Much like a dry cell is a dead cell, a wound that is too moist often has delayed wound healing.

By Holly M. Hovan, MSN, GERO-BC, APRN, CWOCN-AP

Wound assessment is one of the initial steps in determining the plan of care, changes in treatment, and the choice of key players in wound management. However, wound assessment needs to be accurately understood and documented by frontline staff to paint a true picture of what is happening with the wound.

By Emily Greenstein, APRN, CNP, CWON, FACCWS

Last month I introduced you to the concept of how being a wound care professional is often a lot like being a detective. This blog post is going to start our “cases.” I decided, in keeping with the theme, to write it up similar to what you would see in a court document.

By: Emily Greenstein, APRN, CNP, CWON, FACCWS

Being a wound care professional is often a lot like being a detective. You have to decide what caused the wound, what is contributing to its not healing and how you are going to get it to heal. I have decided to start a series of “cases” that are commonly overlooked or seen in the chronic wound care setting. The cases will focus on real-life scenarios—moisture-associated skin damage versus pressure injury, red leg syndrome versus venous stasis ulcer, how to identify pyoderma, and the importance of a moist wound healing environment. This series will also provide practical strategies for overcoming healing obstacles for slow, non-healing, and challenging wounds.

By the WoundSource Editors

Wounds of the lower extremity, such as chronic venous leg ulcers and diabetic foot ulcers, often have a severe impact on patients' quality of life. Symptoms may range from mild to debilitating, depending on the location of the injury and its severity. These types of wounds also affect a tremendous number of people because lower extremity wounds are estimated to occur in up to 13% of the United States population. The estimated annual cost of treating lower extremity wounds is at least $20 billion in the United States.

By Hy-Tape International

According to a published study, the global prevalence of diabetic foot ulcers (DFUs) is 6.3%, with male patients and older adults being the most likely to be affected.¹ This prevalence, coupled with the potential for complications and the severe effect on quality of life the condition can have, makes DFUs one of today's most serious health care issues. To reduce the effects of DFUs and improve outcomes for patients, it is critical that health care professionals rapidly identify DFUs and implement best practice dressing and management strategies.