Wound assessment is the act of understanding a wound. It’s the first step taken by your doctor or wound care specialist and it will determine three important things:
- The treatment plan
- Any changes to the existing treatment plan
- Who the key players in your wound treatment plan will be
Therefore, assessing a wound properly is of the utmost importance. Every step after assessment is dependent on the fact that an educated assessment was made in the first place. That’s why we’ve outlined the wound tissue and drainage types. In this article we’ll concentrate on slough and purulence and by the end of the article you’ll be able to tell the difference between the two.
Slough: A Type of Tissue
Slough is fibrotic, necrotic tissue that needs to be removed to promote optimal healing. In appearance, this tissue starts off as wet, moist, stringy and yellowish, but soon becomes dry eschar that’s thick, black, and leathery. Your wound care specialist will begin treatment by removing slough so the wound is able to heal properly. This is also called debridement, or the separation of skin. During this process the slough will liquefy or dissolve. This may create an odor – anytime wound drainage is present there is a possibility of odor. If there is no presence of odor, the wound is progressing normally. If the odor is light, this may be a sign of normal wound progression too. If the wound is malodorous, it could be the first sign of an infection – but it isn’t always that way. Next, we’ll get into the signs of possible purulence, which is a malodorous, liquified slough that has become infected. But first, here are some of the treatment options for debridement your wound care specialist may proceed with:
- A sharp, bedside debridement
- Debridement in an operating room (with the patient under anesthesia)
- Chemical debridement/Enzymatic debridement
- Mechanical debridement
- Biological debridement
- Autolytic debridement
What is Purulence?
Purulence is when a wound produces pus. Sometimes normal liquefied slough drainage is mistaken for purulence. So, the question is, is your wound infected? Are you showing symptoms of infection? Or is it only slough that you’re wiping away? Knowing the difference may be confusing, because slough is liquified during the debridement process. To know if it truly is pus and your wound is likely infected, look for these symptoms:
- Erythema or redness of the skin; often caused by infection
- Odor, typically an unpleasant odor that can be described as malodorous
- Keeping limb elevated doesn’t help
- Heat at the site of the wound
- Increase in drainage
- Presence of drainage color; for example green, blue, or red
- Fever, chills,
- Nausea, vomiting
Is the Wound Infected?
Is it purulence or slough, that is the question. Purulence occurs when the wound is infective – it’s often the first sign of an infected wound. If your wound is infected with purulence, this is what you should do:
- Clean the wound before you make any notes documenting the odor
- Remember that slough is sometimes confused with purulence; it is also confused with tendon and other underlying structures
- Use your gut – if something looks, feels, or smells off, trust yourself, and let your wound care specialist know
- You’ll know it’s slough by a stringy texture and yellow appearance; when you wash the wound it looks more granular
- You’ll know it’s purulence by looking out for erythema, a foul odor, and other signs of infection
If you think you’re experiencing purulence, let your wound care specialist know. Don’t sit and wonder by yourself. Sitting on an infected wound is never good. Instead, get your wound on the path to faster healing by visiting with a specialist. If you’re sure that your wound is just experiencing natural slough debridement, make sure to monitor the wound closely. Wounds go from normal and progressing to infected faster than you can imagine. Cut back on the risks of infection by keeping the wound clean and applying antibiotic ointment. The key differences between infected purulence and slough are that you’ll notice the signs of infection with a purulent wound.
Visit Wound Care OC for all of your Wound Care needs
Contact Wound Care OC for wound treatment in Orange County, CA
Dr. Faried Banimahd is a board-certified physician specializing in emergency medicine, wound care, and pain management. Our team will work with you to create an individualized treatment plan that meets your needs and unique conditions. Our clinic includes highly trained and experienced physicians, registered nurses, and certified medical staff who work together to provide you with the highest standards of wound care treatments.