Purulent drainage is a sign of infection. It's a white, yellow, or brown fluid and might be slightly thick in texture. It's made up of white blood cells trying to fight the infection, plus the residue from any bacteria pushed out of the wound. There may be an unpleasant smell to the fluid, as well.
Maceration occurs when skin has been exposed to moisture for too long. A telltale sign of maceration is skin that looks soggy, feels soft, or appears whiter than usual. There may be a white ring around the wound in wounds that are too moist or have exposure to too much drainage.
Slough is considered to be part of the inflammatory process consisting of fibrin, white blood cells, bacteria and debris, along with dead tissue and other proteinaceous material. It is the cellular debris resulting from the process of inflammation7.
Don't get your wound wet in the bath or shower.
This keeps the wound too wet and can spread bacteria from other parts of your body into the wound. You can keep your wound dry by using a cast/wound protector or using Press-N-Seal plastic wrap to cover the wound area then tape a kitchen trash bag over the wound/dressing.
Showering is preferable to bathing, so that the wound does not 'soak' in water. Do not use soap, shower gel, body lotion, talcum powder or other bathing products directly over your healing wound; and do not rub the area, as this might be painful and could delay healing.
There is no need to rub soap into a wound, but small amounts of soap or shampoo getting into a wound will not be harmful and can be rinsed out at the end of the shower. If we take a bath, we can rinse the wound with clean water at the end of the bath.
After 48 hours, surgical wounds can get wet without increasing the risk of infection. After this time, you can get your stitches wet briefly with a light spray (such as in the shower), but they should not be soaked (for example, in the bath).
rinse the wound under running tap water for 5 to 10 minutes. soak a gauze pad or cloth in saline solution or tap water, or use an alcohol-free wipe, and gently dab or wipe the skin with it – don't use antiseptic as this may damage the skin.
You should be able to wash normally after your stitches, dressings and clips have been removed. It's usually better to have a shower until the wound has healed to avoid soaking it completely. Afterwards, pat your wound and the area around it dry.
After the initial discharge of a bit of pus and blood, your wound should be clear. If the discharge continues through the wound healing process and begins to smell bad or have discoloration, it's probably a sign of infection.
Chronic wounds may be covered by white or yellow shiny fibrinous tissue (see next article in this series). This tissue is avascular, and healing will proceed only when it is removed.
The number of white blood cells rises and cell death increases, resulting in the accumulation of slough, which provides an environment for bacterial proliferation, increasing inflammation, and wound chronicity. A failure to remove the slough continues to prolong the inflammatory phase and impair healing.
Enzymatic debridement: Sometimes called chemical debridement. A medication is used to break down the dead tissue in your wound. It can be used with sharp debridement. Mechanical debridement: Whirlpool, pulse lavage or wet to dry saline dressings are used to remove dead tissue.
Wet or moist treatment of wounds has been shown to promote re-epithelialization and result in reduced scar formation, as compared to treatment in a dry environment. The inflammatory reaction is reduced in the wet environment, thereby limiting injury progression.
Remember to cleanse your wound daily with gentle soap and water, apply petroleum jelly and cover it with an adhesive bandage for faster healing.
Clean area twice daily with soap and water, and apply a new bandage and ointment after cleaning. There is no need to use hydrogen peroxide or alcohol for cleaning. Continue this care until wound is fully healed. Deep or gaping wounds may need stitches or other wound care from a medical professional.
A cold shower — even just for a few minutes — can work as cold therapy to help you heal, recover and generally feel good, especially after exercise.
Examining a wound
Normal drainage is thin or slightly sticky. Thick, milky drainage is often a sign of an infection. Amount: Most wounds will have moderate drainage at first that slows down as the wound heals. Light or moderate drainage is considered normal.
Once the wound has formed a scab, there is no longer the need to cover it with a bandage as the scab now acts as a protective barrier. Keep the area clean, but be gentle so that you do not accidentally remove the scab.
You may purchase a waterproof dressing, which will come as a bandage film that has adhesive. Apply your waterproof bandage as per the instructions. Stretch it out over the wound to ensure it fully covers it. If you are going swimming or showering, keeping your wound dry will be especially important.
Wash the wound
Before you start, wash and dry your hands. Then, wash out the wound with a large quantity of warm, soapy water as soon as possible. It's also OK to get in the shower and let copious amounts of warm, soapy water flow through the wound. Make sure you flush the wound bed thoroughly.
Changing the dressing
The original dressing should be left in place for at least two days (48 hours) (or as advised by the nurse/doctor), provided that the wound is not oozing. The wound must be kept dry. If the dressing becomes wet from blood or any other liquid it must be changed.
Factors that can slow the wound healing process include: Dead skin (necrosis) – dead skin and foreign materials interfere with the healing process. Infection – an open wound may develop a bacterial infection. The body fights the infection rather than healing the wound.
There are two main types of necrotic tissue present in wounds. One is a dry, thick, leathery tissue usually a tan, brown, or black color. The other is often yellow, tan, green, or brown and might be moist, loose, and stringy in appearance. Necrotic tissue will eventually become black, hard, and leathery.