Sanguineous drainage is the initial discharge produced after an injury or an open wound where the skin is broken. Sanguineous drainage mostly contains fresh, bright-red blood and a clear, yellow liquid called blood serum. Initially thin and flowing, it thickens gradually as the blood clots and turns a deep red color.
Sanguineous discharge is common during the inflammatory phase of wound healing, although it should decrease significantly over time and stop after a few hours in most cases. With some deeper wounds, sanguineous wound drainage may last for a few days but should significantly decrease in volume.
After an injury, injured cells produce inflammatory chemicals that cause adjacent blood vessels to leak or become permeable and draw immune cells to the site of injury. As the clot dries, it forms a scab, which acts as a barrier to keep germs and microscopic dirt particles out of the wound.
What causes sanguineous drainage?
Sanguineous drainage is more prominent in wounds that extend beyond the skin's surface layers, such as deep wounds of complete and partial thickness, which are usually linked with blood vessel injury.
Sometimes, the wound may reopen due to re-injury during the healing process and lead to sanguineous drainage. It may also be seen when old drainage is removed because the skin strips off along with the bandage, causing injury to the capillaries near the skin.
4 types of wound drainage
1. Serous drainage
Serous drainage is thin, watery, and transparent liquid that leaks out, commonly seen in fresh wounds within 48-72 hours during the inflammatory wound healing stages. If you see a large volume of serous leakage, this may suggest a significant bioburden (presence of unsterile bacteria) on the wound.
2. Serosanguinous drainage
Serosanguineous drainage is the most prevalent kind of discharge and is made up of both blood and serum. It is thin, watery, and pinkish or deep red. The pink or red color is caused by red blood cells in the fluid, which is a symptom of capillary injury. This discharge is normal in the early stages of healing because the blood is present in small amounts, and it appears pink.
3. Hemorrhagic drainage
Severe, rapid bleeding from a wound that may be life-threatening is called hemorrhage. Severe, rapid sanguineous drainage is called hemorrhagic drainage. Hemorrhagic drainage is seen when deeper tissues under the skin are injured or when an artery or vein is cut. When an artery is cut, blood may appear bright and burst from the incision. When a vein is injured, the blood may be darker and flow more slowly. Patients with hemorrhagic drainage need immediate medical attention because significant blood can occur and fluid resuscitation or blood transfusion may be required.
4. Purulent drainage
Purulent drainage is also called foul-smelling drainage, and it indicates wound infection. Purulent drainage is a clear, white, yellow, or brown fluid with a slightly thick texture and may or may not have a foul smell. It is a mixture of living and dead cells of infection-causing microorganisms and white blood cells that were sent to the wound site to fight infectious agents. With worsening infection, the amount of discharge increases. Foul-smelling discharge should never be overlooked and requires immediate treatment to prevent the further spread of infection.
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Hernández A. Sanguineous Drainage. Osmosis. https://www.osmosis.org/answers/sanguineous-drainage
WebMD. What Is Purulent Drainage? https://www.webmd.com/a-to-z-guides/what-is-purulent-drainage
Science Direct. Wound Drainage. https://www.sciencedirect.com/topics/medicine-and-dentistry/wound-drainage
Richlen B. Learn How to Determine What Wound Exudate Is Telling You. Wound Care Education Institute. https://blog.wcei.net/learn-determine-wound-exudate-telling
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