How do you treat a wound with a large amount of drainage?

According to wound care experts, proper management of wound exudate is critical for preventing complications and promoting healing. This guide provides authoritative, step-by-step instructions on how do you treat a wound with a large amount of drainage, from selecting absorbent dressings to protecting delicate surrounding skin.

Quick Summary

Managing a wound with heavy drainage requires selecting highly absorbent dressings, such as foam or alginates, and changing them regularly to prevent skin maceration and reduce infection risk. Essential steps include careful wound cleaning, protecting the skin around the wound, and, when appropriate, using techniques like elevation or compression to control swelling and drainage.

Key Points

• Choose Absorbent Dressings: Select dressings like alginates, hydrofiber, or foam that are designed for high exudate to manage drainage effectively.

• Frequent Dressing Changes: Replace dressings as soon as they become saturated to prevent skin maceration and maintain a clean wound bed.

• Protect Periwound Skin: Use a barrier cream or protective wipe on the skin around the wound to shield it from excess moisture.

• Monitor for Infection: Watch for signs like increased pain, redness, swelling, or a foul odor, and seek medical help if they appear.

• Elevate the Area: If possible, elevate the affected limb to help reduce swelling and improve drainage control.

Understanding Wound Drainage

Wound drainage, also known as exudate, is a natural part of the healing process. It consists of fluid that leaks from the wound, which contains vital cells and nutrients that aid in repair. However, an excessive amount of drainage can be a sign of infection or other underlying issues, and if not managed properly, can cause serious complications like periwound maceration (softening of the skin around the wound).

Assessing Your Wound's Drainage

Before starting treatment, it's important to understand the type and amount of drainage you are experiencing. This will help you select the most appropriate dressing and management strategy.

• Serous: Thin, clear, or slightly yellowish fluid. A small amount is normal during the early stages of healing.
• Sanguineous: Red, bloody drainage. Indicates new vessel damage. A small amount is normal initially.
• Serosanguineous: Pinkish-red, thin fluid, a mix of serous and sanguineous. This is also common during healing.
• Purulent: Thick, opaque, and often yellowish, greenish, or brownish fluid, sometimes with a foul odor. This is a sign of infection and requires immediate medical attention.

Step-by-Step Guide to Managing Heavy Drainage

Managing a heavily draining wound requires diligent care. Follow these steps for the best results.

1. Wash your hands thoroughly. Before touching the wound or any dressings, wash your hands with soap and water for at least 20 seconds. Put on clean, disposable gloves to minimize the risk of introducing bacteria.
2. Remove the old dressing carefully. If the dressing is sticking, use a small amount of sterile saline or water to moisten it. This will prevent damage to the new skin and reduce pain. Dispose of the old dressing in a sealed bag.
3. Clean the wound. Use a sterile saline solution or a wound cleanser to gently wash the wound. Avoid harsh antiseptic agents like hydrogen peroxide, as they can damage healthy tissue. Swab or rinse the wound gently, moving from the center outwards to push contaminants away from the wound bed.
4. Dry the surrounding skin. Pat the skin around the wound gently with a clean gauze pad. Excessive moisture on the periwound skin can cause irritation and maceration.
5. Apply a skin protectant. Use a barrier cream, ointment, or a no-sting protective wipe on the skin around the wound. This creates a protective layer that shields the skin from the constant moisture of the exudate.
6. Apply the correct absorbent dressing. This is the most crucial step for a wound with a large amount of drainage. Options include alginate, hydrofiber, and foam dressings, which are specifically designed to handle high volumes of exudate.
7. Secure the dressing. Use a secondary dressing or medical tape to hold the primary absorbent dressing in place. For very heavy drainage, consider a waterproof film dressing over the top to keep the dressing secure and protect it from external moisture.

Choosing the Right Absorbent Dressing

Selecting the right dressing material is essential for effective drainage management. Different dressings offer varying levels of absorption and are suitable for different wound types.

Comparison of High-Absorbency Dressings

Dressing Type	Absorption Capacity	Best For	Considerations
Alginate	Very High	Heavily draining wounds, shallow or deep wounds, bleeding wounds.	Requires a secondary dressing; may adhere to dry wounds.
Hydrofiber	Very High	Heavily draining wounds, cavity wounds, infected wounds.	Gels on contact with exudate; requires a secondary dressing.
Foam	Moderate to High	Light to heavily draining wounds, pressure ulcers, burns.	Provides cushioning; can be self-adhesive; available in different thicknesses.
Superabsorbent	Extremely High	Wounds with very heavy or excessive drainage.	Often used as a secondary dressing; can be expensive.

Protecting the Periwound Skin

Continuous exposure to wound exudate can lead to skin breakdown, a condition called maceration. The skin becomes soft, white, and fragile, increasing the risk of infection and delaying healing. To prevent this, ensure the following:

• Regular Dressing Changes: Change the dressing as soon as it becomes saturated. For heavily draining wounds, this might mean several times a day.
• Barrier Creams: Apply a protective barrier cream to the skin immediately surrounding the wound. This acts as a shield against the moist environment.
• Avoid Over-Absorbent Dressings: While counterintuitive, using a dressing that is too absorbent can dry out the wound bed, which is also detrimental to healing. Find the right balance.

When to Seek Professional Medical Care

While home care is effective for many wounds, certain signs indicate the need for immediate medical attention. Consult a healthcare provider if you notice any of the following:

• Increased or Persistent Pain: Worsening pain is a common sign of infection.
• Signs of Infection: Redness, warmth, swelling, or a foul odor emanating from the wound.
• Changes in Drainage: If the drainage becomes thick, cloudy, or green, it could signal an infection.
• Fever: A fever is a systemic sign of infection.
• Delayed Healing: If the wound shows no signs of improvement after several days of home care.

Advanced Treatment Options

For persistent, heavily draining wounds that don't respond to conventional dressings, a healthcare professional might suggest more advanced therapies. These can include:

• Negative Pressure Wound Therapy (NPWT): This technique uses a vacuum to pull fluid from the wound, helping to reduce drainage and promote healing.
• Compression Therapy: If swelling (edema) is a contributing factor to the drainage, compression wraps or stockings can help reduce the fluid buildup.
• Medicated Dressings: Some dressings contain antimicrobials like silver or iodine to help combat potential infection.

Conclusion: Effective Management is Key

Successfully managing a wound with a large amount of drainage is a process that relies on careful assessment, proper technique, and the right supplies. By using highly absorbent dressings and taking precautions to protect the surrounding skin, you can create a favorable environment for healing. For any signs of infection or if drainage is not improving, remember to consult a healthcare professional. For more in-depth information on wound types and treatments, you can refer to authoritative sources like Cleveland Clinic. Consistent, informed care is the most reliable path to recovery.

Frequently Asked Questions

What kind of dressing should I use for a wound with heavy drainage?

For heavy drainage, use highly absorbent dressings such as calcium alginates, hydrofiber dressings, or specialized foam dressings. These materials can absorb large volumes of exudate while maintaining a moist healing environment.

How often should I change the dressing on a heavily draining wound?

You should change the dressing on a heavily draining wound as soon as it becomes saturated. In some cases, this may be multiple times per day. The goal is to keep the surrounding skin dry and protected.

Is it normal for a wound to have a lot of drainage?

A certain amount of drainage is normal during healing, especially in the early stages. However, a large or increasing amount of drainage, or if it changes in color or odor, can indicate a problem like an infection and warrants medical attention.

How can I protect the skin around my wound from drainage?

To protect the skin around your wound (periwound skin), use a barrier cream, ointment, or a no-sting protective wipe. These products create a protective layer that shields the skin from maceration caused by constant moisture.

What are the signs that my wound drainage is infected?

Signs of an infected wound include thick, cloudy, or discolored (yellow, green, brown) drainage with a foul odor. Other indicators are increased pain, redness, swelling, warmth around the wound, and fever.

Should I elevate a heavily draining wound?

Yes, elevating the affected area can help. Elevation uses gravity to reduce swelling (edema) and improve blood flow, which can help control excessive drainage from the wound.

When should I see a doctor for wound drainage?

You should see a doctor if the drainage increases significantly, changes to a thick or colored fluid, develops a foul odor, or if you experience increasing pain, redness, warmth, or a fever. Also seek help if the wound doesn't show signs of healing.