A lot of interesting things come out of large healing wounds, most of them are normal; some are not. Wound drainage comes in many forms and some can be alarming at first.
- Bleeding - SOME bleeding is normal, especially during packing changes. There are lots of new blood capillaries being built in your wound and those can be disturbed during packing changes. Gushing blood or large clots are not normal, call your doctor. There have been cases where an excision went too close to a larger vein and this can be scary if the vein opens up during a packing change. Anything more than about a teaspoon of blood should have a doctor look at it. For large amounts of blood that aren't stopping, go the the nearest ER. Sutures bleeding one week after surgery is normal, bleeding after two weeks is not normal (unless it is from individual stitch holes that are too tight).
Exudate - This is the by-product of healing that those going through open wound healing will start seeing in the wound at about 5 days post-op. At first glance, you may think you have an infection since there will be little gobs of "gunk" in your wound. Exudate can be white, yellowish, grayish, greenish or light brown. Exudate can also have a slight odor, it is normal.
Exudate is a collection of dead cells and other materials discarded as your body heals itself. It needs to be gently cleaned out of the wound twice daily and this is part of role of packing changes. Exudate can be rinsed out of the wound bed with a hand-held shower sprayer, just flush the entire wound out. You may go though periods of very heavy exudate drainage (lots of healing going on) or minimal exudate drainage (healing slowing down).
- Serous Fluid - Serous drainage is common in all wounds, you've probably noticed in the past when you've had a small wound that it sometimes wept a clear or yellowish fluid during healing. Serious fluid is yet another interesting wound healing byproduct that the body creates to help dilute the toxins produced by bacteria and toxic products being released from dying cells. In addition, the serous fluid helps to carry plasma proteins and leukocytes to the wound site. Lastly, the serous fluid assists in removing bacterial toxins, dead cells, debris, and other products of inflammation. Small amounts of Serous fluid are normal.
- When to be concerned: For those with a closed incision (sutures), this fluid can build up inside the surgical site and the drainage can be a large (scary) amount of yellow/orange fluid. Usually nothing needs to be done other than to cover the open spot to protect the clothes, but your surgeon should still be contacted because similar fluid can come out of the wound in the case of a rare but more serious wound complication. Your doctor will most likely want to take a closer look when large amounts of Serous drainage are present.
- Pus - This is NOT normal. Pus coming from either a closed or open incision needs immediate attention from a doctor. Pus is produced by inflammatory bacterial infections and is part of the body's immune response. Presence of pus indicates infection that needs treatment ASAP.
† Strong odor with pain, redness and swelling usually indicates infection, call your doctor ASAP.
- It can be difficult to tell some of these drainage types apart, so here is a quick visual reference:
- Pus - grayish to greenish to whitish. Pus is generally dense and has a consistency of glue since it is composed of immune cells and other debris from the infection battle raging in the wound. It frequently has a distinctive smell. Since it is dense, it flows slowly.
- Exudate - whitish to greenish to brownish. Exudate usually has the consistency of cottage cheese -it does not flow like a liquid. Might have a slight smell. Usually, you can dislodge it easily with a q-tip or gauze.
- Serous - light yellow to pinkish to clear. Serous Drainage is watery and flows easily.
This page last updated: 11/08/2010