Types of Drainage From a Surgical Wound

If you or a loved one has had surgery recently, you may be concerned about the surgical incision site—how to care for it, what it looks like, and if it appears to be healing properly.

One thing to be aware of is drainage from the site, known as exudate. While it can be alarming to see drainage from a surgical wound, usually it's perfectly normal and even expected.

That said, in some cases, drainage can be a sign of infection—something that's fairly easy to prevent by taking simple steps like proper handwashing. Keeping an eye out for early signs of infection is also important. The earlier an infection is identified the faster it can be treated, which reduces healing time.

This article will describe the difference between normal and abnormal wound drainage and when to call your healthcare provider.

Normal vs. Abnormal Wound Drainage

Drainage from a surgical wound can tell you a lot about whether the site is healing properly or not.

Here are some differences between normal and abnormal wound drainage that can help you to evaluate if you should alert your healthcare provider that something is wrong.

Types of Normal Wound Drainage

Here's a closer look at the various types of normal drainage.

Clear Drainage

Clear, thin, and watery drainage is called serous exudate.

This type of fluid is normal from a wound in the early stages of healing, typically in the first 48 to 72 hours after the incision is made.

While this drainage is normal in small amounts, large amounts of it warrant a call to your surgeon or another healthcare provider.

In some cases, serous fluid can actually weep from the skin, even where there is no trauma or incision.

This typically happens in response to a medical condition or after massive amounts of fluid are given, such as during treatment for severe trauma.

Slightly Pink Drainage

Serosanguineous drainage is thin, watery drainage that's made up of small amounts of blood and a clear, yellowish fluid called serum. This drainage may appear slightly pink from the small number of red blood cells that are present.

This discharge is normal in the early stages of healing, as the blood is present in small amounts. A very small percentage of blood in the fluid can make serum appear pink.

Types of Abnormal Wound Drainage

These types of drainage can indicate that there may be a problem with how a surgical wound is healing and can help you know if you should get it checked by a physician.

Bloody Drainage

Sanguineous drainage is abnormal wound drainage that typically has a thick amount of blood present in it. This bloody drainage is not typical of a healing wound.

It may indicate that the wound hasn't been treated gently enough during incision care, you've been too active too quickly after surgery, or another type of stress is affecting the incision site.

Report this type of drainage to your surgeon or another healthcare provider.

Mostly or All Blood

Hemorrhage is the term for severe bleeding from a wound. It can be life-threatening, depending on the amount of blood loss, how difficult the bleeding is to control, how long the bleeding goes unchecked, and other injuries.

The term hemorrhage refers specifically to blood being lost at a rapid rate. Medical attention is an absolute necessity for treating hemorrhages and may include blood transfusions and intravenous (IV) fluids.

In terms of drainage, hemorrhage is pure blood or nearly all blood. Seek treatment immediately.

Colorful Drainage

Purulent drainage, better known as pus, is not normal in a properly healing incision. This type of drainage can be a variety of colors, including white, yellow, grey, green, pink, and brown.

Assume that this type of drainage is a sign of infection until proven otherwise. Color alone does not indicate infection, but a change from clear drainage to colorful drainage should be reported to the surgeon.

Foul-Smelling Drainage

In addition to being a variety of colors, purulent (pus) discharge may also have unpleasant or foul smells.

While a smell is not always present, it is typical of this type of infection.

Foul-smelling discharge should not be ignored as it is never considered normal.

Clear discharge with a foul odor should be considered a sign of infection until proven otherwise.

Amount of Wound Drainage

While the type of drainage is important, the amount of drainage may be more important, depending upon the type.

For example, if there is a small amount of bleeding from a wound, it may not be alarming, but blood gushing from a wound, known as a hemorrhage, is a life-threatening condition.

In general, the amount of discharge and the amount of blood in the discharge should decrease in the days following surgery. More discharge is expected in the first few days following surgery.

After that, most wounds will typically have less discharge with less blood in it until there is no discharge whatsoever and the wound has completely closed.

Summary

Normal wounds have normal drainage—it's clear or there is a little bit of blood or yellow color. The amount of drainage, and the amount of blood in it, should lessen as the wound heals.

Abnormal wounds look angry and have angry drainage. They get worse—more tender, more drainage, more bleeding, more swelling.

You should see your doctor if the drainage from your wound is colorful, increases in volume, or smells bad.

If there is a lot of bleeding from the wound, seek emergency medical care.