You’re changing a dressing on a resident’s surgical wound and notice the gauze is soaked with a yellow, foul-smelling fluid. This is wound drainage, and knowing how to accurately describe what you see can be the difference between a healing wound and a serious infection.
What is Wound Drainage?
Wound drainage (also called exudate) is the liquid produced by the body in response to tissue damage. It is a natural part of the healing process, but the type, amount, color, and odor tell us how well the wound is recovering. As a CNA, you will primarily observe drainage during dressing changes or peri-care. You will often hear terms like serous (clear/thin), sanguineous (bloody), serosanguineous (pink/light red), or purulent (thick/pus-like).
Why Wound Drainage Matters in Your Daily Care
Monitoring drainage is a vital part of infection control. A sudden increase in the amount of drainage, a change in color, or a foul odor can be the first sign that a wound isn’t healing correctly or that an infection is spreading. Your documentation and report to the nurse allow the care team to intervene early—potentially preventing sepsis, hospitalization, or pain for the resident. Your eyes are the nurse’s early warning system.
What You’ll See During Your Shift
You will encounter drainage when assisting with dressing changes or while providing hygiene care near wounds or incision sites. You might notice dry, clean dressings, or you might see dressings that are wet, oozing, or soiled. You need to describe the drainage specifically, not just say “it looks wet.”
“Nurse Jamie, I just changed the dressing on Mr. Henderson’s surgical site. The drainage is purulent—it’s thick, yellow, and has a strong odor. It saturated the entire 4×4 gauze. The skin around the wound looks red and warm to the touch, too.”
Common Pitfall & Pro Tip
⚠️ Pitfall: Using vague terms like “gross” or “nasty” to describe drainage. While that might be how you feel, it doesn’t help the medical team assess the clinical picture.
Pro Tip: Be objective and descriptive. Use your training terms: Is it clear, red, or yellow? Is it thin or thick? Is there an odor? Quantify it if you can (e.g., “soaked through half the dressing”). The more specific you are, the faster the nurse can determine the right treatment.
Memory Aid for Wound Drainage
Think “See SP” to remember the common types:
- Serous = Serene/Clear (Normal healing)
- Sanguineous = Sanguine/Blood (Fresh bleeding)
- Purulent = Problem/Infection (Pus, needs reporting)
If you “See SP,” you can quickly categorize the fluid during your busy shift.
State Test Connection
Expect questions on the CNA exam asking you to identify which type of drainage indicates infection (purulent) or which observations require immediate reporting to the nurse (odor, increased amount, color change).
Related Care Concepts
Observing wound drainage connects directly to infection control practices, like proper hand hygiene and disposing of soiled dressings. It also relates to vital signs, as an infected wound often causes a fever. Understanding drainage is also key when performing output measurement if the resident has a wound drain device like a Hemovac or Jackson-Pratt bulb.
Quick Reference
✓ Key types: Clear (Serous), Pink (Serosanguineous), Red (Sanguineous), Yellow/Green (Purulent) ✓ When to report: Foul odor, thick consistency, purulent color, or sudden increase in amount ✓ Care reminders: • Wear clean gloves and standard precautions for all dressing changes • Note the color, odor, and amount of drainage on the flow sheet • Never clean a wound unless specifically assigned and trained • Report any redness, warmth, or swelling around the wound edges immediately
Bottom line: You are the frontline defender against infection. When you accurately assess and report wound drainage, you are protecting your resident’s health and dignity.