Exudate: The Type and Amount Is Telling You Something

Published on January 29, 2016 by Keisha Smith, MA, CWCMS

Wound care clinicians need to know about the different types of exudate – and how much is present – for successful wound treatment and healing.

Ooze. Pus. Secretion. The drainage that seeps out of wounds can be called many things, but as wound care clinicians know, the technical term is exudate. This liquid, which is produced by the body in response to tissue damage, can tell us what we need to know about the wound. And while we want wounds to be moist, we don’t want them to be overly moist. Finding that balance can sometimes be a bit tricky – which is why it’s so important to know all about exudate.

Types of Exudate

First, let’s start with the types of exudate we most commonly see in our patients’ wounds. They are:

  • Serous – a clear, thin and watery plasma. It’s normal during the inflammatory stage of wound healing, and smaller amounts are considered normal. However, a moderate to heavy amount may indicate a high bioburden.
  • Sanguinous – a fresh bleeding, seen in deep partial- and full-thickness wounds. A small amount is normal during the inflammatory stage.
  • Serosanguineousthin, watery and pale red to pink in color.
  • Seropurulent – thin, watery, cloudy and yellow to tan in color.
  • Purulent – a thick and opaque exudate that is tan, yellow, green or brown in color. It’s never normal in a wound bed, and is often associated with infection or high bacteria levels.

Quantity of Exudate

Besides knowing the different types of exudate, you also need to be aware of the amount present in your patients’ wounds. This can be key for proper assessment, and help you choose the best wound treatment. The different exudate levels include:

  • None present – the wound is dry.
  • Scant amount present – the wound is moist, even though no measurable amount of exudate appears on the dressing.
  • Small or minimal amount on the dressing – exudate covers less than 25% of the bandage.
  • Moderate amount  – wound tissues are wet, and exudate involves 25% to 75% of the bandage.
  • Large or copious amount – wound tissue is filled with fluid, and exudate covers more than 75% of the bandage.

Always take into account the amount of exudate when selecting the dressing. We want to promote moist wound healing, but with no adverse effects from too much moisture, such as maceration of the periwound.

What Do You Think?

When it comes to documenting exudate, do you see one type being identified more than others – like the well-known serosanguineous? And what about the amount of drainage – do you use the terms listed above, or does your clinic use percentages instead? We would love to hear how your facility typically documents exudate, and if you encounter any specific challenges or successes with identifying or treating wounds based on exudate. Please leave your comments below.

Wound Care Education Institute® provides online and onsite courses in the fields of Skin, Wound, Diabetic and Ostomy Management. Health care professionals who meet the eligibility requirements may sit for the prestigious WCC®, DWC® and OMS national board certification examinations through the National Alliance of Wound Care and Ostomy® (NAWCO®). For more information see wcei.net.

Keisha Smith, MA, CWCMS

Keisha Smith, MA, CWCMS, is a freelance digital marketing consultant who works with clients in healthcare, law and behavioral health. Her specialties include content creation, social media and brand clarity. As an eight-time Wild On Wounds conference staff member and an alumna of WCEI's training program for wound care marketing professionals, she loves the exceptional passion of clinicians who treat wounds. She frequently finds herself advising friends and family to keep their minor wounds warm and moist.