Drainage bags attached to the wound can be one of the best ways to manage excess fluid.

The amount of wound drainage that a patient exudes is largely depends on the type of wound and the individual. However, while some wounds will naturally (and healthily) produce a lot of exudate, this excess wetness can be very uncomfortable for the patient, and can quickly produce strong odors, as well as damage surrounding tissue, which can lead to wound infection. If you’ve recently undergone a procedure that will produce high levels of exudate during the healing process, here are some issues to look out for, as well as some great management tips:

Carbon and Charcoal Dressings

Wound discharge, when coming at a fast pace and in large volumes, can quickly soil the dressings, causing them to become overly saturated. This can lead to smelly bandages, which can be an embarrassment for the patient. Luckily, many dressings have been developed that incorporate odor-capturing ingredients, such as carbon and charcoal, which help to minimize any pungent smells from wound healing. Additionally, some topical wet dressings, such as metronidazole, contain antibacterial agents that help minimize the growth of bacteria, which are often the main cause of the foul smells in the first place.

Wicking Dressings

Similar to some fabrics that are used in athletic clothing and some types of socks, some dry dressings are made from materials that spread any wound exudate laterally over the entire fabric, rather than just soak through the material at the wound’s wettest spots. This process, called wicking, can be found in a number of dry dressings, such as Medline’s ABD Pads and Smith and Nephew’s Exu-Dry pads, which can replace layers of gauze with one multi-layer contourable dressing.

This type of dressing can be particularly helpful for procedures with multiple drainage locations, as well as those that have uneven wetness along the length of the healing wound.

Wound Drainage Bags

Although drainage bags have largely gone out of favor with the development of a wide variety of modern dressings, the array of drainage bags currently available still provide good options for those complex wounds, particularly those with a fistula. Drainage bags are particularly useful if they can be connected to the wound without disrupting the surrounding skin. Wound drainage bags should always be fitted and prescribed by a clinician – although a patient may learn how to use a drainage bag, it can be difficult to properly fit the bag to the wound, and the bag needs to be regularly removed and emptied without pulling on the surrounding skin or leaking onto the other portions of the skin, which can prompt an infected wound.

Measuring Wound Drainage

To examine how much exudate a wound has (or continues to have) is key in assessing the healing timeline for the wound as well as how well the current methods are managing the wound drainage.

  • Wound drainage should be examined on a regular basis – either every 24 or 48 hours is standard for most wound types. With things like wound drainage bags or vacuum closures, the fluid and solids in the drainage can be easy to measure with the use of scales; however, dry dressing assessments have to be made on saturation levels.
  • At these intervals, clinicians should note how saturated each dressing or drainage type is, and subsequently how well it is containing the wound exudate. If multiple clinicians are making these assessments, the designations for certain levels of saturation should be complimented with photos, and, if possible, the dressings should be weighed post-use.