Serous drainage is a clear to yellow fluid that leaks out of a wound. It's slightly thicker than water. It's the fluid that makes your bandage look and feel wet. This type of wound drainage is a normal part of your body's healing process.
Purulent drainage is a thick and milky discharge from a wound. It often indicates an infection and needs treatment as soon as possible. Regularly inspecting a wound is an integral part of the healing process. Understanding how purulent drainage differs from other types of drainage can help identify and treat it.
Slough is considered the by-product of the inflammatory phase of wound healing. An essential component of wound bed preparation is the removal of slough from a wound bed. Slough not only contributes to delayed wound healing, it also prevents an accurate wound assessment and can also harbour biofilms.
Slough will always show signs of stringy textures, yellow coloring, and will be more granular after cleansing. Purulence will always emit an odor after cleansing and will show signs of infection and erythema.
We've all heard about slough… most of us have seen it, debrided it, and even watched it change from wet (stringy, moist, yellow) to dry eschar (thick, leathery, black). Slough is necrotic tissue that needs to be removed from the wound for healing to take place.
Surgical Debridement with Sharp Instruments
This is a type of debridement where devitalized tissue (slough, necrotic, or eschar) in the presence of underlying infection is removed using sharp instruments such as a scalpel, Metzenbaum, and curettes, among others.
Healthy granulation tissue is pink in colour and is an indicator of healing. Unhealthy granulation is dark red in colour, often bleeds on contact, and may indicate the presence of wound infection. Such wounds should be cultured and treated in the light of microbiological results.
Scabs can sometimes turn yellow as a wound heals. However, yellow scabs can sometimes indicate a skin infection, such as impetigo and cold sores. Although scabs are usually dark red, they can go through many color and texture changes while the wound is healing.
Pain. Pain is an essential indicator of poor wound healing and should not be underestimated. Pain can occur from the disease process, surgery, trauma, infection or as a result of dressing changes and poor wound management practices.
Redness. The area may be swollen, sore, and red in color right after you've sustained your injury. This is normal as blood is being sent to the area to supply oxygen and other nutrients for healing. But if the wound is still red and swollen after five days, it's a sign that your body is not healing correctly.
You should keep a wound moist and covered for about five days.
As the wound begins to dry, a crust starts to form in the outer layer. If the crust is yellowish and if there is a formation of pimples on or near the wound, it could be septic. Sores that look like blisters. If there is a formation of sores which look like pockets of fluid around the area, they could be septic.
Indicators of wound infection include redness, swelling, purulent exudate, smell, pain, and systemic illness in the absence of other foci. Subtle signs of local wound infection include unhealthy “foamy” granulation tissue, contact bleeding, tissue breakdown, and epithelial bridging.
Wounds should be desloughed to avoid infection, remove devitalised tissue and promote autolysis. The wound should be rehydrated and exudate controlled to prepare the wound bed for healing. As a guide, if the wound has dry adherent slough on the wound bed, a dressing that will donate moisture should be selected.
YELLOW NECROTIC WOUND WITH HIGH EXUDATE
AIM: Remove slough and absorb exudate. Use hydroactive dressings, or alginate dressings covered by a foam dressing.
The presence of slough may indicate the wound is stuck in the inflammatory phase (chronic wounds) or the body is attempting to clean the wound bed in preparation for healing.
Symptoms include increasing pain, swelling, and redness. More severe infections may cause nausea, chills, or fever.
Generally, people who develop sepsis will start feeling more tired or confused and may have shaking or chills. However, these symptoms can also appear with other types of infection, so it's important to call your healthcare provider if you have an infection that is not getting better with treatment.
Q: Is it better to bandage a cut or sore, or air it out? A: Airing out most wounds isn't beneficial because wounds need moisture to heal. Leaving a wound uncovered may dry out new surface cells, which can increase pain or slow the healing process.
Wounds need to be covered so that they can heal properly. When a wound is left uncovered, the new surface cells that are being created can easily dry out. When these important cells dry out, it tends to slow down the healing process. A wound should be covered using a clean bandage.
Leaving a wound uncovered helps it stay dry and helps it heal. If the wound isn't in an area that will get dirty or be rubbed by clothing, you don't have to cover it.
A chronic wound is a wound that does not heal in an orderly set of stages and in a predictable amount of time or wounds that do not heal within three months are often considered chronic. Chronic wounds often remain in the inflammatory stage for too long and may never heal or may take years.
Phase 2: Inflammation
This phase can be the most painful of all. It is often when you'll notice some reddening, heat and pain as your blood rushes to the wound to clean it. Inflammation generally takes up to six days and should go away.