Common Types of Wound Drainage and How to Take Care of Your Wound

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Common Types of Wound Drainage and How to Take Care of Your Wound

Wound drainage is common in many types of wounds (including open wounds) while they are healing. The type of wound drainage you experience can help to know how well the wound is healing. Some types of drainage from wounds also indicate the presence of bacteria and that the wound is infected.

Wound drainage is also called exudate. Some types of normal wound drainage look like thin clear watery fluid, whereas others may resemble clear blood fluid. It’s common for infected wounds to ooze yellowish fluid that may be thin to a thick consistency. Depending if there is blood in the drainage from an infected wound, the wound may leak fluid that has a cream-coffee appearance.

If you have to care for a wound, it’s important to know the common types of wound drainage. This can help you know if the wound is healing properly or if wound drainage is showing signs of infection.

In this article, you will learn about the various types of wound drainage. I will also look at the best type of wound care and how to treat infected cuts.

Types of Wound Drainage

Let’s briefly look at the types of wound drainage and what they can mean for you.

  • Serosanguineous. Thin watery drainage that has a pink to darker red color.
  • Sanguineous. Dark red drainage which is blood and usually appears from deep wounds.
  • Serous. The thin watery fluid that is clear and often drains from wounds as they are healing.
  • Seropurulent. Thin watery drainage similar to serous but has a milky, coffee-cream color and indicates an infection in the wound.
  • Purulent. Milky white drainage that oozes from wounds and is usually an indicator of infection.
  • Hemorrhagic. Dark red blood drains from the wound and may come out in spurts because an artery has been damaged or the wound is not healing properly.

What is Wound Drainage?

Drainage from wounds or exudate is a necessary part of the healing process. According to doctors from MedicineNet, exudate fluid contains protein and cells that drain from blood vessels. This usually happens during the inflammation part while the wound is healing. This gives the appearance that the wound is “sweating” – which in Latin is “exsudare.”1

Let’s look in more detail now at the different types of wound drainage and what they mean.

Serosanguineous Drainage

Serosanguineous drainage is a common type of fluid that appears on wounds. It is mostly composed of clear fluid and contains small amounts of blood serum. Doctors from the University of Florida Health say that serosanguinous exudate can also be a yellowish color with traces of blood.2

Doctors from the American Academy of Family Physicians say that serosanguinous wound drainage is often present with partial-thickness wounds that have some skin loss. For example, ulcers and blisters often ooze serosanguinous fluid. 3

Sanguineous Drainage

The type of fluid from a wound referred to as sanguineous drainage mostly comprises of fresh blood. Dr. Richard White who is a senior researcher with the National Health Service says that sanguineous drainage often leaks from a wound if there has been trauma to blood vessels.4

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Usually, sanguineous wound drainage is common when recent wounds are healing. This bright red drainage will be present in deep wounds and partial-thickness wounds. If sanguineous exudate occurs later in the healing process, it may be an indicator that there is further damage to the wound site and the wound isn’t healing properly.

Serous Drainage

A wound leaking clear fluid is usually referred to as serous. Serous drainage is another type of common wound drainage that is a normal part of the healing process. This clear, watery fluid drains from most types of wounds. According to researchers from Johns Hopkins Medicine, normal serous exudate can also be a clear yellowish or straw-like color.5

Dr. Wanda Lockwood who trains nurses in wound care and management explains that plasma-containing serous drainage is present when epidermal tissue has been damaged. The skin may have an appearance of blistering and be sore to touch. In some types of wounds, serous exudate develops because of a secondary wound and is a sign of infection.6

For example, doctors from the Victoria State Government say that serous exudate from a wound that is excessive or increases in amount may indicate a complication with the wound healing.7

Seropurulent Drainage

Seropurulent drainage is a mixture of blood and pus that oozes from a healing wound. The combination of blood and pus gives seropurulent exudate a yellowish cloudy color. This drainage type is thicker than normal drainage and, because there is pus in the drainage, it indicates an infection.

Purulent Drainage

Purulent drainage has a milky color to it and is a sign that this type of wound is infected. Doctors from MedicineNet say that purulent is drainage containing pus and can indicate a bacterial infection.7

Johns Hopkins Medicine says that purulent exudate may also have other colors than milky-white. The wound ooze may be light brown, yellow, or green. It will have a thick consistency and give off a bad smell.5

Wounds that leak purulent drainage are sometimes caused by an abscess that starts of as a large painful lump filled with pus. When the abscess drains, it will secrete smelly odorous thick pus. Purulent leakage is sometimes present after surgical operations and may also show signs of inflammation, warmth, and pain around the healing wound.6

Purulent discharge is not a normal part of wound healing as it indicates an infection.

Hemorrhagic Drainage

Hemorrhagic drainage can also occur if there is an infection in the wound or there has been severe trauma. Dr. Richard White, who was quoted earlier, says that wounds that don’t heal properly cause capillaries to break down and this results in thick red drainage.4

Of course, any kind of serious damage to the skin that causes deep cuts will result in mild to heavy bleeding. If there is a lot of hemorrhaging, it’s essential that the blood flow is stopped as soon as possible.

In wounds that are healing, Dr. Richard White explains that spontaneous bleeding from a wound may be a sign that an infection is present.4

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Both purulent drainage and bloody hemorrhagic drainage can be serious complications in wound care and may require extra medical supervision.

How to Measure Drainage

The color, consistency, and smell from wound drainage can help doctors to monitor how the wound is healing. However, it’s also just as important to measure drainage to diagnose any complications that occur as the cut or open wound is getting better.

For example, the ANZ Journal of Surgery reports that surgeons should accurately measure surgical wound drainage.9

It is also important to measure levels of drainage appearing on wound dressings as they are healing. Dr. Nancy Morgan who specializes in wound care says that the wound drainage on dressings is measured by the percentage of fluid saturation as follows:20

  • Lack of drainage means that the wound is too dry and this will hinder healing.
  • Scant drainage occurs when there is no fluid on the dressing but the wound is moist.
  • Minimal exudate is when drainage fluid covers up to 25% of the dressing.
  • Moderate drainage on the wound will mean that the bandages are wet and drainage affects up to 75% of the dressing.
  • Heavy drainage can indicate complications with wound healing and this is the case if over 75% of the bandage is wet.

Wound Drainage and Other Symptoms of Infected Wound

If you have to care for a wound, it’s important to pay attention to the type of wound drainage and its amount. You should take note if the fluid leaking from the wound is clear or cloudy-looking, if there are any noticeable odors, or if the drainage is increasing.

Dr. John Cunha on MedicineNet explains about the signs and symptoms of infected wound drainage. The first sign of an infected wound is the presence of yellow or green drainage around the wound. You may also feel that the skin surrounding the wound is warm to touch. The wound will probably also look red and inflamed.10

Another warning sign of an infected wound with drainage is red streaks that radiate from the wound site. Red streaks from a wound can indicate that the infection is in your blood system. Dr. Barbara Blasko on eMedicineHealth says that if you notice red streaks coming from a wound, you should seek medical help immediately.11

Wound Care and Wound Healing – What do and What to Avoid

There are many situations that call for wound care to help speed up the healing process and prevent complications.

The journal BMJ says that cuts, abrasions, burns, and other injuries to your skin will cause some amount of leaky fluid as the wound heals. Also, some people are affected by ulcers that become chronic and require constant care to bandage the affected area and stop wound drainage.12

For example, people with diabetes often get ulcers on their feet. Other conditions that result in wounds and requiring proper care to change dressings are hidradenitis suppurativa (an inflammatory skin disease) and cellulitis which is a bacterial infection.

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Here are the best ways to care for wounds and what you should avoid doing.

How to clean a cut and first aid wound care

According to Dr. John Cunha, all that is required for most cuts to prevent infections is to wash the cut with soap and water. After that, it’s important to keep the cut clean and dry.10 Although, for some wounds, a moist dressing can accelerate healing.

To clean a cut and care for a wound properly, doctors from the American Academy of Dermatology recommend certain first-aid steps for wound care.14

This is what you should do to treat a cut or a wound:

  1. Stem any bleeding by applying pressure with a clean cloth or bandage. Hold for 10 to 20 minutes if necessary.
  2. Clean the wound thoroughly with soap and water.
  3. Remove any foreign objects from the wound as they can cause infection.
  4. If you need to use tweezers to get small bits of debris out, always sterilize them with alcohol first.
  5. Never prod or dig deep into the open wound as this can cause a deep wound infection.
  6. Apply a moist ointment to help the injured skin heal (at the end of the article you will find out why honey is good for healing wounds).
  7. Change dressings daily and wash the affected area with soap and water and reapply ointment.
  8. Continue applying and changing the dressing until the wound or cut heals.

Following the above steps will also help to prevent scars and scabs forming on the wound. If a scab does form on the wound, never try to pick a scab off. Removing the scab too early can result in permanent scarring and bacteria may get into the wound.

Although many dermatologists recommend petroleum jelly on a wound, there are many reasons to use safer alternatives to petroleum jelly.

How to treat an infected cut

What should you do if the cut or wound shows signs of infection like yellowish thick drainage that gives off a bad odor?

Doctors from the Victoria State Government say that treating an infected cut or wound depends on the extent of infection. Some wounds require medical help to prevent delayed wound healing. However, there are some things you can do to treat an infected cut.13

You should do the following for cuts that have signs of a mild infection:

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  • Keep your wound dressed and change dressings regularly if fluid drains from the wound. Wounds heal better when they are warm, and the dressing will prevent a temperature drop in the wound area.
  • For chronic wounds, most doctors recommend moist dressings.
  • Eat a healthy diet to help build your body’s immune system. Vitamin C, vitamin A, copper, and zinc are essential nutrients that help wounds heal faster.
  • If possible, exercise regularly to increase blood flow.
  • See your doctor if the infection in the wound gets worse or show signs of spreading.

Hydrogen peroxide 3% on open wounds

There is much discussion on whether 3% hydrogen peroxide is beneficial for wound care.

For example, Dr. John Cunha (quoted earlier) says that you could use hydrogen peroxide to help wash debris from a cut or wound. However, hydrogen peroxide should not be used to help heal a wound long-term.10 However, doctors from the Mayo Clinic discourage the use of hydrogen peroxide to wash a cut. They say that it could irritate your skin.15

According to the British Journal of Anaesthesia, applying 3% hydrogen peroxide to wound long-term could damage skin tissue. Doctors say that hydrogen peroxide on an open wound can cause oxidative tissue damage and is not suitable for wound treatment.16

However, recent research into using hydrogen peroxide in wound management shows that it could have potential without causing tissue damage. Researchers have found that if the correct amounts of hydrogen peroxide are used, it could help to sterilize wounds and actually accelerate the healing process. But, more research needs to be done into the clinical use of 3% hydrogen peroxide to heal wounds.17

The general advice on how to wash a wound is: never use 3% hydrogen peroxide at home to clean and wash wounds. Dr. Laura Martin on WebMD says that all you need is mild soap and cool running water to wash a wound and help prevent infection.18

Alcohol on wounds

The same is true for alcohol. You should never apply alcohol to a wound to disinfect the skin. Alcohol can irritate the skin and also cause damage to skin tissue. The only time to use alcohol in wound care is to disinfect any items or instruments that will touch the open wound.

Honey for wounds

One way to speed up wound healing naturally is to apply honey as a wound dressing. Honey contains powerful antibacterial and antimicrobial properties and also provides a moist environment for skin healing.

For example, the Journal of Wound Care reported that honey can help to treat open and infected wounds. In one study, applying honey as a wound dressing reduced the number of bacteria in an infected wound by over half. After 3 weeks of treatment, nearly 90% of patients had no pain when dressings were being changed.19

For more information on how you can use honey for burns and remedy other health conditions, please see my article on the wonderful health benefits of Manuka honey.

When to See a Doctor

Most minor cut, scrapes, and skin abrasions heal within a few weeks if you care for them properly. However, if you see any signs of a wound infection, you should seek prompt medical help.

According to Dr. Barbara Blasko on eMedicineHealth, you should see a doctor for wounds in the following circumstances:11

  • The wound continues to bleed for over 5 minutes or the hemorrhaging is happening in spurts.
  • A nail, pen, or pencil has caused a puncture wound.
  • You think that part of the item that caused the wound is still in the wound.
  • You can’t clean dirt out of the wound with mild soap and water.
  • You have signs of an infection like fever, red warm skin, purulent or seropurulent drainage.
  • You notice red streaks coming from the wound.
  • There is fatty tissue or muscle tissue visible in the wound.
  • The injury was close to your eye.

Read my other related articles:

Medical Sources

  1. MedicineNet. Medical definition of exudate.
  2. AAFP. Common questions About Pressure Ulcers.
  3. UFHealth. Serosanguineous.
  4. WorldWideWounds. Modern exudate management.
  5. HopkinsMedicine. Wound care.
  6. RN. Wound management comprehensive.
  7. MedicineNet. Medical definition of purulent.
  8. HealthVicGov. Coding of wound ooze in specific examples.
  9. ANZ J Surg.2015 May;85(5):327-9.
  10. MedicineNet. Cuts, scrapes, and puncture wounds.
  11. eMedicineHealth. Puncture wound.
  12. BMJ. 2006 Feb 4; 332(7536): 285–288.
  13. BetterHealth. Wounds – how to care for them.
  14. AAD. Proper wound care.
  15. MayoClinic. Cuts and scrapes: first aid.
  16. BJA. 2002 April 1;88(4):597-599.
  17. Med Princ Pract. 2017;26:301-308.
  18. WebMD. Wound care true or false.
  19. J Wound Care.2007 Jul;16(7):317-9.
  20. WoundCareAdvisor. Exudate amounts.
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