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Exudate Management

Exudate Management

The amount of exudate produced correlates with the extent of the inflammation. This is because the wound fluid (exudates) is the transport medium for the cells that are recruited at the wound site. The composition of wound fluid in "complicated" wounds (i.e. pressure ulcers, diabetic ulcers and vascular ulcers) has been shown to differ markedly from that in acute wounds. This composition is seen as an indicator for healing1.

Wound Moisture
It is now known that wounds heal much better in a moist environment. The moist environment improves collagen synthesis and increases the rate of granulation and epithelialisation.

A wound in itself is not dry. The tissue in the wound however can dry-out by exposure to the air. This situation needs rectifying as the healing process cannot take place when the tissue is dehydrated. Restoring the wound environment to a "moist" condition should be a principle aim of wound management.

Although there's no absolute known measure of the production of wound fluid, it is generally accepted that the condition at the wound surface should be kept moist to optimise wound healing.

Wounds can be extremely wet due to inflammation, oedema or infection. This extreme, sometimes described as maceration is detrimental for the cells that are responsible for wound healing. The aim of wound management thus should be the absorption of the surplus of wound fluid thereby restoring the tissue to a "moist” condition conducive to healing.

1) Winter GD: Formation of scab and rate of epithelialization of superficial wounds in the skin of the young domestic pig. Nature 1962; 193:293-294

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