Exudate management



"Wound exudate is not just an inert fluid - understanding its components and causes will help to improve care." 1

WHAT IS EXUDATE?1

Wound exudate is the product of fluid which leaks from capilliaries into body tissue. In the early stages of healing, inflammation will increase the permeability of capilliaries, leading to an excess level of fluid entering the wound. This is expected to decrease over time in healing wounds, but in non-healing wounds, which may be stuck in the inflammatory phase, exudate may remain at elevated levels.

Healing may be affected if there is too much or too little exudate.


MOIST WOUND HEALING

Epithelial cells require moisture to move from the wound edges to re-epithelialise or close the wound.

In a dry wound, these cells move below the wound bed to find a moist area.

In a moist wound environment, however, the cells are able to migrate directly across the wound bed, which results in faster healing rates.


MANAGING EXUDATE1

Choice of dressing to manage exudate is important.

A number of properties can be considered in dressing choice such as the desired moisture balance and the dressing's ability to assist healing or prevent wound deterioration.

While many dressings will absorb exudate or manage exudate through evaporation, other considerations for dressing characteristics include:

Retention: Dressings that form a cohesive gel tend to maintain their structure during use and may reduce the risk of periwound maceration, by preventing fluid from tracking through the dressing.

Sequestration: The ability of some dressings, demonstrated in vitro, to trap bacteria and components of exudate within the dressing.

According to the World Union Wound Healing Society Consensus Document on wound exudate and the role of dressings, an integrated approach to assessment should be taken.1

Management of exudate and related problems

exudate_1

"Effective exudate management will require advice from a multidisciplinary team and the creation of individualised management plans."1


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