For individuals who have undergone surgery, it may be disconcerting to see drainage coming from the surgical site. The most common exudate is serious drainage which is normal and is expected from surgical wounds. However, other forms of exudate may signal an infection or a complication.
Types of Drainage
The liquid produced by the body as a reaction to tissue damage is known as wound exudate or drainage. Understanding the types of drainage can help an individual understand what is normal and what may be going on in the wound.
1. Sanguineous Drainage
This is fresh blood commonly seen in full-thickness or deep partial-thickness wounds. The blood is thick in consistency and bright in color. A small amount of sanguineous drainage is expected during the inflammation stage since it is an indication of proper blood circulation. However, sanguineous drainage a few hours after surgery may be an indication of trauma to the surgical site.
2. Serosanguineous Drainage
In this type of exudate, it is characterized by pale red, watery, and thin drainage which indicates capillary damage.
3. Serous Drainage
Serous drainage results from other fluids and protein present in human tissue. It is usually clear but may appear slightly-brown in some instances. This type of exudate is normal and is expected from a surgical wound as it contains proteins, white cells, and sugars vital in wound healing. However, excess amounts of this type of exudate may signal high levels of bioburden. This relates to the abundance of bacteria or other microorganisms which may be harmful to the healing process.
4. Seropurulent Discharge
When drainage from the wound is off-color or milky, it likely indicates an infection. The exudate may also appear as tan or yellow in color and cloudy, watery, or thin inconsistency.
5. Purulent Discharge
One type of discharge an individual does not want to expect from a wound is a purulent exudate. This is not normal and indicates an infection of the surgical site. Purulent discharge contains dead bacteria, white blood cells, different inflammatory cells, and pus. As for its color, it appears as either brown, green, yellow, or tan. With regard to its consistency, it is opaque or thick.
Doctors and nurses carefully evaluate and monitor the consistency and color of the wound as it is vital in determining the stage of healing or possible wound issues. With regards to the level of drainage, Wound Care Advisor provides the percentage of total saturation which is as follows.
- Copious Drainage: This is the most severe. Saturation is at 75 percent, and immediate medical intervention is required.
- Minimal Drainage: It occurs when wound dressings are damp. Saturation is at 25 percent.
- Moderate Drainage: happens when the bandages are completely soaked. As for saturation, it falls between 25 to 75 percent.
- Scant Drainage: which falls below 25 percent in terms of saturation. The wound dressing is slightly damp.
Apart from the saturation of the dressings, healthcare providers pay close attention to the surgical site’s odor, particularly the strength of the scent. If the site omits a foul-smelling scent, then it requires immediate evaluation.
Why It Matters?
The appearance of the drainage coming from the wound is not the only point of concern by healthcare providers. Apart from the appearance, doctors pay attention to the amount of exudate coming from the injury. For example, hemorrhagic drainage needs immediate medical attention.
One method of discerning if there has been damage to an artery or a vein is the character of blood flow. If the blood comes in spurts, then it means an artery has been ruptured. On the other hand, if the blood flows in a steady stream, then it indicates damage to a vein.
For seropurulent and purulent drainage, the amount of exudate is little, and it oozes slowly. Nonetheless, regardless of the amount, this type of drainage needs immediate medical care.
As for serous and sanguineous drainage, this exudate is normal after surgery. However, an excess sanguineous or serous drainage from the incision days after surgery indicates either a complication or infection. The healthcare provider must be notified of this drainage as soon as possible.
Also, excessive bleeding in the wound may likely indicate blood vessel injury. It may also mean unhealthy blood clotting due to medications such as blood thinners.
When to Worry?
Drainage that is yellow or white from the surgical incision site five days after a major operation must be given notice to the healthcare provider. Such exudate may indicate infection or a complication and warrants a quick trip to the ER.
As with any wound, pus must not be overlooked. Blood tinged or clear fluid may appear normal but may indicate something else if it comes in large quantities. Stay on the safe side and have wounds, especially surgical incision sites, regularly evaluated and cleaned by a licensed healthcare professional.
Proper Wound Care
Proper care for a surgical incision is needed right after surgery to aid wound healing. Also, it may limit the formation of scars, prevent infections as well as pain. An individual needs to keep the surgical incision site clean and must change wound dressings based on the instruction of their healthcare provider. With regard to reducing the likelihood of an infection, the following tips should help.
- Check the incision site each day and evaluate it for signs of infection.
- Change dressings as recommended by the doctor.
- Follow doctor’s orders regarding the duration of drying the wound before applying a bandage.
Apart from the tips mentioned above, one must not remove strips or stitches from the surgical incision site without instructions from the doctor. Avoid rubbing or scrubbing the surgical incision site. Also, as much as possible, avoid using powder and lotion on the site, and limit exposure to sunlight.
Until the healthcare provider says it is alright to take a bath, then keep the site dry. Before bathing, cover the surgical site with a plastic bag to prevent water from leaking into the wound and dressings.
Itching, numbness, tingling, tenderness, and mild soreness may be felt, especially around the surgical incision site. As long as the drainage is clear, there is no cause for concern. Take note, however, that drainage that is excessive in amounts five days after the surgery is not healthy and the healthcare provider should be notified.