Photo Credit wound image by Andrey Rakhmatullin from Fotolia.

com According to Medscape, exudate refers to the draining of liquid from open wounds in the human body. Exudate comes from the serum around inflamed, damaged tissue created by the mechanical force that created the wound or opening in the skin or mucus membrane. Mucus membrane refers to the mouth, nose or other natural openings in the body.

Serous
Serous wound drainage looks clear or straw colored. The serous material arises from protein and fluid in the tissue. At times, serous material will leak through swollen skin when a person suffers a critical illness. The serous drainage supports the healing process and contains protein, electrolytes, sugar, white cells and some microorganisms. Platelets and fibrin used in the clotting process appear in the fluid in the first 48 to 72 hours of formation of a wound to prevent bleeding. Serous wound fluid occurs as a normal process of healing. Prepare Histology Slides Hundreds of High Purity Products For Research & Industry. Buy Here! www.polysciences.com Sponsored Links

Serosanguinous
Serosanguinous fluid appears pink due to a small number of blood cells mixing with serous drainage. "World Wide Wounds" describe a consistency of thin and watery for serosanguinous fluid. Serosanguinous fluid appears normally in the healing of wounds.

Sanguinous
Sanguinous liquid means red drainage from trauma to a blood vessel that may occur with the cleaning of a wound or excessive movement of the individual with a wound immediately after a

wound emerges. The consistency appears thin and watery with sanguinous fluid. Sanguinous represents an infrequent finding in a wound.

Hemorrhaging
Hemorrhaging indicates a leaking blood vessel putting out blood. The consistency is thicker than sanguinous fluid. This situation may constitute an emergency requiring a physician's assistance to control bleeding if large amounts of blood flow from the wound site. Hemorrhaging represents an abnormal discovery in a wound.

Purulent
Purulent effluent refers to yellow, gray or green drainage that comes out of a wound when infection invades the area. The fluid contains pathogenic microorganisms along with white cells, inflammatory cells and dead or dying bacteria. The volume of the exudates increases when an infection occurs.

Cerebral Spinal Fluid

After traumatic accidents, a head or back wound may leak a clear, slightly sticky fluid from the chambers in the head or the canal around the spinal cord. Leakage of cerebral spinal fluid constitutes an emergency. The site of the leaking cerebral wound requires creating a sterile situation to allow the fluid to flow out, but not allow bacteria to enter.

Slough and Necrotic Tissue

In addition to exudates, abnormal tissue may exist in the wound, especially in chronic wounds or wounds with slow healing. Researchers Enoch and Price, writing in 2004 for the journal "World Wide Wounds," define slough as a yellow fibrinous tissue consisting of fibrin, pus and protein material. Necrotic tissue containing dead cells and debris forms in the wound from an inadequate blood supply to the area. The health care provider removes both slough and necrotic tissue in order to allow a wound to heal.

Read more: http://www.livestrong.com/article/184098-types-of-exudate-fromwounds/#ixzz208PZLJLR

Types of Normal Wound Drainage

Serous Drainage:

Serous drainage is clear and may be slightly yellow or colorless in appearance. It is thin and watery and may make a bandage wet without leaving a stain of color. Serous exudate, or discharge, is normal from a wound in the early stages of healing, typically in the first 48-72 hours after the incision is made. While serous fluid is normal in small amounts, large amounts of this clear fluid leaving the incision line should be reported to the surgeon. In some cases, serous fluid can actually weep from the skin, even where there is no trauma or incision. This typically happens when the person has severe pitting edema due to a medical condition or after massive amounts of fluid are given, such as during treatment for severe trauma.

Serosanguinous Drainage:

This is a thin, watery drainage that is composed of both blood and serum. This discharge may appear slightly pink from the red blood cells that are present. This is normal in the early stages of healing, as the blood is present in small amounts. It is important to keep in mind that a very small percentage of blood in the fluid can make serum appear pink.
Types of Abnormal Wound Drainage

Sanguinous Drainage:

This type of drainage has a larger amount of blood present than in serosanguinous drainage. This drainage is not typical of a healing wound and may indicate that the wound hasn't been treated gently enough during incision care, or being too active too quickly after surgery. This type of drainage may also be present in wounds that require vigorous cleansing, such as a wet to dry dressing change that is intended to remove dead tissue from the incision line. This type of drainage, or drainage that is increasingly bloody with no clear cause, should be reported to the surgeon.

Hemorrhage:

Severe bleeding from a wound can be life-threatening, depending on the amount of blood loss, how difficult the bleeding is to control, how long the bleeding goes unchecked and other injuries that may be present. The term hemorrhage refers specifically to blood being lost at a rapid rate. Medical attention is an absolute necessity for the treatment of hemorrhage, and may include blood transfusions and fluid resuscitation.

Purulent Discharge (Pus):

Better known by the common name of pus, purulent drainage is not a normal finding in an incision. This type of exudate can be a variety of colors, including white, yellow, grey, green, pink, and brown. In addition to being a variety of colors, purulent discharge may also have an unpleasant or foul smell. While this smell is not always present, it is typical with this type of infection. Any signs of infection, including the presence of pus, should be reported to the surgeon immediately.
Amount of Wound Drainage

While the type of drainage is important, the amount of drainage may be more important, depending upon the type. For example, if there is a small amount of bleeding from a wound, it may not be alarming, but blood gushing from a wound, known as hemorrhage, is a lifethreatening condition. In general, the amount of discharge, and the amount of blood in the discharge, should decrease in the days following surgery. More discharge is expected in the first few days following surgery; after that, most wounds will typically have less discharge with less blood in it until there is no discharge whatsoever and the wound has completely closed.
Sources:

Advance For NPs and PAs. Wound Exudate: An Influential Factor In Healing. Accessed May 2012.http://nurse-practitioners-and-physicianassistants.advanceweb.com/article/wound-exudate.aspx?CP=2

The drainage systems are chosen based on the needs of the patients or the preference of the surgeon. There are 3 types of drainage systems; the closed drainage system is a system of tubing or other apparatus that is attached to the body to remove fluids in an airtight circuit that prevents any type of environmental contaminants from entering the wound or area being drained. The open drainage system is a tube or apparatus that is inserted into the body and drains out onto a dressing. Lastly the suction drainage system uses a pump or mechanical device to help pull the excessive fluid from the body. Types of drains vary depending on the type of surgery done, type of drainage needed, type of wounds, and how much drainage may be expected.

Penrose drain is an open drainage system that is placed on the incision line. The drainage will then collect onto the dressing, letting gravity work to pull the drainage out. Hemovac drain is a closed drainage system. The drainage works by suction that pulls the drainage from the body into a collection tank. Jackson Pratt (JP) drain is another closed drainage system that also uses suction to pull the drainage from the incision into a collection tank. T-Tube drain is used for mostly for patients who have undergone gallbladder surgery or surgery of the surrounding tubes draining the gallbladder. This type of drainage most resembles a T and drains into a collection bag. It is very important for the nurse to note all aspects of wounds when charting or describing the wound to other medical professional. The nurses should make sure to note the consistency, odor, color and amount of drainage. Noting the amount of drainage from a drain system is fairly easy if it enters into collection unit, by pouring the drainage into a measuring device. When a Penrose drain system is used the nurse should weigh the dressings that the drainage is draining onto it and note the weight of the dressing in her notes.

1. Penrose Drains
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The Penrose drain, named for American doctor Charles Bingham Penrose, is a simple means of wound drainage. A length of soft rubber or silicon tubing is placed in the wound area to facilitate drainage. After surgery, blood may pool, leading to the proliferation of bacteria. A simple drainage tube like the Penrose drain can aid in preventing such infections. Patients with hydrocephalus have also found this sort of drain to be useful in removing excess cerebrospinal fluid.

Negative Pressure
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Negative pressure wound therapy is commonly used in burn patients as well as chronic or severe wounds. The wound is covered with gauze or foam dressing that is then covered with a drape layer. A vacuum system is then applied to the wound to remove dead tissue and excess fluid. The system also promotes blood flow to the wounded area to assist in new cell growth, closing of the wound, and formation of granulation tissue to promote healing. Negative pressure systems also discourage bacterial growth, which in turn discourages infection.

Jackson-Pratt Drains
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The Jackson-Pratt drain, or bulb drain, applies continuous suction pressure to a wound through the use of a flexible bulb that not only provides suction to the wound, but stores the removed fluids. Applying pressure to the bulb creates the

suction necessary to clear the wound. Once the bulb is full, it can be removed and cleaned, then replaced to be used again. Sponsored Links Read more: Types of Wound Drains | eHow.com http://www.ehow.com/list_7501836_typeswound-drains.html#ixzz208S1pZUL