Wound Assessment- Wound Drainage and Odor

Wound Drainage

When assessing wounds, it is important to assess the amount and type of wound drainage, as well as any odor associated with the wound. Drainage and odor can provide important clues regarding wound health, such as the possible presence of infection.

Wound Drainage

Wound drainage can be described according to the following four characteristics/descriptors:

  • Type- Drainage can be described as serous, sanguinous, both serous and sanguinous (serosanguinous), purulent or seropurulent. Serous or sanguinous drainage (or a combination of the two) is normal, while seropurulent or purulent drainage is often a sign of infection.
  • Color- Normal wound drainage is clear or pale yellow in color; red or dark brown drainage signifies old or new bleeding. Wounds that have a distinctive blue-green drainage present often have Pseudomonas
  • Consistency- wound drainage consistency may be thin and watery or thick. Thick drainage hints at the possibility of infection.
  • Amount- Most wounds will have some drainage present. Wounds that have no drainage at all are often desiccated or necrotic. Minimal to moderate drainage should be considered normal, providing the amount of drainage is not disproportionate to the amount of necrotic tissue present, which could signify that infection is present. A copious amount of drainage should raise a concern about the presence of infection.

When assessing drainage, it is important to consider the type of dressing that is being used, as the dressing may have absorbed a large amount of fluid; in addition, it is important to ask when the dressing was last changed.

Wound Odor

Because wound odor can be subjective, it is important not to attach too much importance to its presence; on the other hand, a strong or foul odor may signify infection and should be taken into consideration along with other factors, such as amount and type of drainage.

Wounds should be assessed for odor after debridement (if necessary) and wound irrigation. Keep in mind that odor might not be from the wound itself, but may instead be from an old dressing. Unpleasant odors may also be due to body odor or incontinence.

Certain microorganisms have distinct odors. Proteus is reminiscent of ammonia, while Pseudomonas is often described as “sickly sweet”. Once you have smelled these odors, they are easy to recognize the next time you encounter them.

Wound Care Certification Online

If you enjoy learning about wound care management, or your job requires you to manage clients with wounds, you might consider becoming a certified wound care professional. The online wound care certification education offered by Wound Educators allows you to study in the comfort of your own home, at your own pace. Our wound care certification for nurses and healthcare professionals will allow you to advance your career on your own time! 

Sources

Fleck, C. (2006). Palliative Dilemmas: Wound Odor. Wound Care Canada, 4(3). http://cawc.net/images/uploads/wcc/4-3-fleck.pdf

Meyers, B (2008). Wound Management: Principles and Practice. 2nd edition. Pearson Prentice Hall. Upper Saddle River, New Jersey. pg. 48-50.

65 Comments

  1. I had a dorsi flap reconstruction and I have now fistulas and I had a bulging bump and it popped and it’s draining and its thick greenish gooey and bright green dots are also draining. Thiis has been going on for 10 years my body developed these canals fistulas and pus builds up and they burst out of nowhere and the drainage starts fevers I get nauseated and vomit a lot and it’s extremely foul odor that comes out of the drainage toxic almost

  2. My Mother may have a pseudomonas infection on her heel, there was an ulcer due to the cast putting pressure on the heel. They have used several different antibiotics, bactrim, clotrimazole and may try a new one, once culture comes back.
    I didn’t notice a bad smell until after she had a bath.
    Could water or moisture cause that?
    She had a mrsa infection about a month ago, but it is gone. She is presently living in a nursing home.

    1. I’ve had this in a fistula and the nurses used 1 part vinegar tin10 parts sterilized water. This may work and I would ask the nurses to see if they could do this for your mom. Lots of excellent studies have been done due to drug resistant bacteria.

  3. Hi there,I read your blogs named “Wound Assessment- Wound Drainage and Odor – WoundEducators.com” on a regular basis.Your writing style is witty, keep up the good work! And you can look our website about proxy list daily.

  4. i have a burning wound and the thing is my wounds smell like the orange part of an egg us that normal it’s really painfull and it’s on my hand and it’s not just the wound my whole hand hurt and i can barrly move it

  5. So I have a post-surgical wound vertically down my stomach that opened up and won’t heal….so my wound care team debrided it and put sheets of honey with collegen in it,then put a bandage over it and said to not shower or remove it for a week …well the wound looks nasty ,I seen it when sweat made the bandage move, and it smells like feet….is this the stuff they put in it,or a result of sweat under the bandage,

  6. I have 3 wounds on top of my foot. They smell like Dog Crap others can smell it. I’m pretty sure that’s not good

  7. Hi i have a wound that covers most the bavk of my calf its open and drain alot and im in so much pain ive been in the hospital alot for infections because i am now immune to oral anti biotics ive had this wound for about a month and a half now and it just keeps spreading but the pain is terrible what would you recommend and i am diabetic

  8. I have sensitivity to cold or metal on my right side that hurts and a boil coming up that the odor smells like rust it’s been like that for a little while what could it be

  9. I’m 14 and recently bad a push bike accident, sliding 2-3 meters after speeding down a hill with no breaks. I have 3 main grazes, one going down my whole right thigh, whole right shin and the back of my left thigh. Some small grazes on my 3 middle fingers on my left and one on my right palm (I’m very stupid). Whilst in hospital, my wounds have weeped (the yellowish substance) a lot, but the doctors dint do anything because of how large the wounds are they said it amount was perfectly normal.After having ‘surgery’ (being knocked out to clean the wounds thoroughly and put dressings on them) they weeped occasionally, after a few days they began to weep again, but not as much. Recently (4 days after hospital) the wound of my shin started to weep, at least i think. A dark brown substance began draining from one spot on my leg. Its gone through copper lining, a blue ‘thing’ (it might be a moisten anticoat, but its quiet thick), the dressing and then a bandage (similar to a compression bandage) that’s used to keep the dressings on. It was dripping through it onto my foot, so i folded the bandage (to apply more pressure and stop it from dripping) 3 times and it still went through, but didn’t drip. Should i be concerned of this? Its a watery substance, a bit thicker than water, but not as thick as blood.

  10. I had an I & d two weeks ago on my inner thigh. The wound is still rather large, 4cm wide and 3cm deep. I’m changing the packing twice a day and cleaning with peroxide as directed by my surgeon. Every time I change the packing it’s green and bloody and smells bad. It also soaks the gauze covering the packing to the point I have to change it multiple times a day. I’m also still in a lot of pain. I feel like my surgeon is blowing me off because it’s not a major surgery. Any advice? I’m at my wits end.

    1. I have a very similar issue… although there was no packing done, but everything else sounds the same! This I&D was done 2months ago! I’ve been to ER twice, given oral antibiotics and sent home, but the drainage hasn’t stopped, tonight has a a putrid smell and I’m at my wit’s end! Can someone please respond… I finished another round of antibiotics a week ago! Why won’t this heal!?

  11. I had a fistula created in my arm for dialysis. I had the surgery revised 10 days ago. The incision is about 10. Inches long held together with staples. The thing is…my arm swells and hurts so much that I used a heating pad to relieve the pain. Well it actually just had a “burst” and has drained a ridiculous amount of red tinged fluid. When I say a large amount, I’m talking about enough fluid to drench a hand towel. It smells like ammonia. What do you think? It felt a whole lot better after it poured out. But it just builds back up. I covered it up but it just soaks through the bandages.

  12. I cut my hand a month ago with glass while washing a glass cup. It left a huge gash on my hand, and then the skin around it fell off slowly. Now my hand is oozing out a thin, yellow liquid. It has no smell though. Is this normal?

  13. I met with an accident and my right knee got wound without knowing it i played in swimming pool and as a result pus formed and i met a doctor he cut near the wound and drained the pus i think around about 100 ml of pus may be drained now the problem is the wound healed but the cut that the doc made creates pus and it drains daily it’s been around a week still no improvement can you suggest anything to cure it.

  14. I’m diabetic and I have had two toes removed
    because staph and Mercer infection. I have another infection now and the smell is horrible I have never had a infection put out a smell like this one. Does the bad meat smell mean this infection is so much worse?

    1. I know what you mean about the smell. I’m so paranoid that other people will smell that coming from me – and my wound site was from a hysterectomy, so forget about intimacy

      Ugh

  15. 18 yrs ago I had a hysterectomy. The scar site has never stopped seeping a thick clear foul smelling secretion all along the incision site. I have gained weight which makes it worse because the surgery left me with a large gouged out area at the scar site & flesh has always hung over the incision, and when I weigh more, more flesh hangs over

    It frequently gets infected; red, sore, & inflamed. I have been given anti-fungal cream, which works, but nothing stops the smelly seepage & the infections always come back. It is impossible to keep that area dry.

    I have recently been diagnosed Type II diabetic

  16. Hi.
    I have a wound vac on my abdomen be from a post surgical infection after a large complex hernia repair. I have a low immune system due to autoimmune disorders (more than 1) that have caused issues in the past with cellulitis and post surgical infections. I have been on wound vac for 3 months now and my wound was improving from a 24cm, 10cm and 13 cm deep to 5 cm , 4cm deep and 4cm now and nice dark red and no infection .but.. Monday during my wound vac change my wound was dark green . I did use lanocaine once during this time and my nurse thought maybe I didn’t dillute it properly , when I explained it is 5% lanocaine viscous and I used only a quarter to half tsp and 30 cc water I don’t think she thought that was the cause . But the lanocaine wasn’t dilluted to good because I had to flush line with a little more water. I also ran out of kci simplace and ordered a box online from a different company but it was sealed in the kci box and the individual dressings were sealed and I used that the previous Friday before this Monday dressing change. I normally use regular vac foam that gives me welted blisters and itch from that tape abd it rips my skin off with the dressing tape but when I ran out another time . My nurse grabbed this dressing from her office and it didn’t rip my wound as much and the tape was tagaderm and though it itches still it didn’t bleed as much or hurt removing the simplace tape.
    But I’m worried these I ordered may have been expired ,maybe?
    Has anyone ever heard of this happening? By the way, no fever or chills . So no infection sign but my nurse says it looked like it’s been burnt. I will say also the outer edges are burning need and are red and inflamed too now .
    I’m embarrassed about this because I ordered from another place besides kci. Kci wanted $479 for a case of simplace . My insurance doesn’t approve simplace , so I bought it a little less expensive elsewhere.
    Now I know regular simplace from kci works well with me , was this one I bought elsewhere expired, stored in the heat or worse a fake ? Today I see my nurse, I’m hoping since Wednesday we used the regular foam that maybe it removed the green ,doubtful .
    I’m embarrassed to tell my surgeon I may be the reason for the complication.
    I am planning on going through nursing school in the Winter , after I heal. Becoming certified as a wound care nurse. I feel really stupid for doing this . I feel I should know better. I’m so embarrassed to tell my surgeon.
    I also wasn’t self diagnosing . My nurse thought the simplace was legitimate also.

    1. I’m so sorry to learn of all the difficulties you are having. It must be very frustrating. You should contact your surgeon asap and tell him as much information as possible. If you have a wound care professional in your location I recommend you have it evaluated. I am happy that you wish to pursue wound care certification. It is extremely valuable. Best of luck!

  17. I woke up a few days ago and noticed my right cheek area of my face was swolen. Then, while I was at the office it started bleeding a little. The next day a little more blood with some pus started to drain and it was stinky. I also felt some soreness in on my cheek amd slight soreness to the right upper part of muy gums in my mouth. I think I may have been bitten by something while sleeping with the window open in my room. The part that worries me most is the smell. What is this and should I go to the ER? Aside from this, I don’t feel ill at all. Please advise.

  18. I fell on my knee 4 days ago taking most skin off in a 1×1 inch area. Thought it was drying and to sleep, it a bandage with Neosporin n it. Next day, green watery off of the skinned patch. No smell but painful. What do you Think? And cover it or not?

  19. I have a wound that I got 2 months ago on my goats fence. It is now black and has a really bad odor. It also had green pus coming from it. What do I do??

  20. I had Osteomyelitis in my left foot after a botched surgery in 2008 it resulted in the amputation of all my toes and half of the foot in 2017 .about 2 months after the amputation I had a small hole in the sole of my foot that turned into an ulcer about 50mm in Dia its now heald but today it started to ooze very thick foul smelling pusie looking blood what is going on

  21. I have wounds on several parts of my body that that drain o. There own …. I’m native my mom makes a special remedies for everything for this its rose water which helps detox the body and helps bring out all bad toxins and bad spirits so when she spray my body each time the all start to drain well I had a bump on my hip I thought was a spider bite that had been growing and getting hot and had a head and was filled with pus but it had popped when I was getting up outta my bed and started draining on it’s own non stop yellowish white mixed with what looked like sum. Blood it had just stopped for some reason but I could tell there was still hella that needed to still drain so I pushed on it as much as I could bare the pain and this pretty big black thing came out and then it was draining more and quicker…… I have had abscesses and what not b4 so I know some about this kind of this but the black thing scared me since I’m not used to it …. I don’t vote to doctor’s much and always use my own self medicate way is this black this something I should be concerned about it was only yesterday so I’m not sure if my wawound is getting better yet or not it still has some leaking which is normal

  22. I have an open wound and the drainage is thin watery and pale yellow and there is never any odor in the drainage what does this mean does this tell me that there is no infection

  23. Have a pressure ulcer on hip for last 3 months. Being treated by home health by saline packing. The ulcer appears to not be as deep but has gotten bigger in diameter and has tunnelled about an 1″. It is still draining a bloody, semi clear discharged enough to drain through the dressing in few hours. The home health people says this is a good thing to drain, but how long should it drain?

  24. Hi, I read your post about Wound Assessment. Could you possibly recommend a wound specialist? I’m currently residing in Alabama and if I tell you what I’ve been put through you probably wouldn’t believe me. I the patient had to request a leg culture. The wound dr refused to give me any antibiotics until now. That the culture came back so high it couldn’t count them all! I can’t afford to lose my leg. Please point me in the right direction of good wound care. Please. Thank you.

  25. I need advice. I fell on my shin 4 weeks ago and got a very small wound. I put bnt power on and after a plaster. Not knowing it must of been infected. I noticed around the wound was red with a darken. I visited a friendly who gave me antibiotics. I revisited h to show improvement but I was recommended to a boe doctor. Anyway I went and the doctor says the wound has to be cleaned d and scraped. I not a doctor so I let it b doe. After I was tod its a minor surgery. The wound was cut ad I’ve been in pain sine last Saturday. The wound is as large as the palm of my hand and round it the skin is soft, soggy with water like a but n and the sin peels off and that makes the wound larger. I’ll be going back to my doctor.
    Can u tell me if its normal and what should the doctor do. I also feel pricking sensation under the soft watery saggy skin. I did all the right this. Please tell me what this means

  26. I have a very similar issue… although there was no packing done, but everything else sounds the same! This I&D was done 2months ago! I’ve been to ER twice, given oral antibiotics and sent home, but the drainage hasn’t stopped, tonight has a a putrid smell and I’m at my wit’s end! Can someone please respond… I finished another round of antibiotics a week ago! Why won’t this heal!?

  27. I had emergency surgery a month ago on my palm. Diagnosis was salmonella. I immediately started 28 days of Bactrin DS (twice per day), and levofloxacin (750mg once per day). the wound is still open 2mm. I keep the wound bandaged and dry, in the evenings I remove the bandage and let it dry out. During each bandage change I irrigate the wound by running tap water on it, then dry and re-bandage. I originally had clear watery discharge the first couple of weeks. Now during physical therapy for the hand I have a thicker slightly yellowish discharge. Is this discharge normal or something to worry about being on the antibiotics.

    I know salmonella wound infections are very rare. I

  28. Hi I just had a question I had a abecess on side of my buttock and went to clinic care it got drained and pack 3 times they said it looks good but it’s been 4 weeks and I’m still weeping pus I’m diabetic I don’t that’s why it’s taking a while what should I do

    1. Debbie, Diabetes can negatively affect wound healing. We suggest visiting a wound care specialist. You can find one in your area through the ABWM.

  29. Someone please help me I am begging. My fiance has charcot-marie-tooth disease he is currently incarcerated he had a partial foot amputation last year since he’s been incarcerated he has and pressure ulcer on the bottom of his amputated foot he went to the wound clinic multiple times and they keep draining the fluid from these abscesses from the pressure ulcer he’s been on multiple antibiotics since January the last time he went to the wound clinic they made an incision in his heel and the needle they use to drain the fluid went all the way to his bone the small incision has been draining a clear yellowish fluid constantly for almost 3 weeks now when he pushes on the top of his foot in the morning thick white stop comes out of the wound on the bottom of his foot followed by the clear yellowish fluid please help the doctor say that he has an antibiotic-resistant infection what should I do I don’t want to lose my fiance.

  30. I have had an open wound on heel that is draining thick, serous, fluid, has a foul smell, and slough that seems to be coming off on its own. Can a wound heal with slough?

  31. I had a hip replacement surgery in 7/31/18. Spent one night in the hospital. Wound up catching a nasty infection. My calf spilt open and green drainage spilled out. Smelled like a dead cat! I’ve had 4 picclines. They leave it in for 2-3 weeks then remove it. To then put in another Piccline for 2-3 weeks. I have been put on oral antibiotics. Even some kind of powdered antibiotic that was specially made for what I have. It will keep the infection at bay. Then when they tell me to stop it. Within a week the severe burning pain is back along with the green blue drainage. I don’t know who to go to next or what to do. Amputation is not a option for me. Any advice would be greatly appreciated. Thank you I wish everybody going through any medical problems the best.

  32. My husband is diabetic and he have an open big wound above the heal and he is been at wond centers we use cream I clean it 2 times a day wash it with soap and water dry it put cream put dressing it’s not healing yet he have hard time walking lots pain and now I noticed lots blood and yellow stuff come out and smells bad what is the smell means? Please help

  33. Hello my husband has had a grandular cyst for over a year he’s been to wound care we have tried a variety of meds and salves silver nitrate iodine antibiotics both oral and cream fungal creams to no avail it would blister up in tiny water blisters a puncture biopsy proved it to be non cancerous and not connected to spine or lower back it started as a cauliflower shaped place about the size of a silver dollar it later spread into an angry shape and would blister fester and swell drain off an on he is still seeing wound care dr he’s not diabetic but does have fatty liver I learned that by making a past of sterile water and turmeric and applying it to his area and placing a sterile huge abdominal bandage on it has done better than anything we’re still seeing dr and with this COVID-19 deal makes it difficult thought I’d share may help someone else he claims it’s helped his pain and the turmeric seems to be working it has pulled a lot of fluid and drainage off the area and doesn’t look as swollen or angry thought I’d share thank Gwendolyn

  34. Hi my name is Alicia and I had got the flesh eating bacteria after a c section and I had to have surgery and currently on a wound vac and my drainage is a pill yellow but there is a smell coming from the vacuum part is that normal

  35. I had surgery a week ago to replace my breast implants. Now the drainage on my right looks almost black and smells rotten. What I should do?

  36. Hi I had punctured wound on my left leg had 1 stitch after 5 days my wound infected went to doctor they cleaned it and changed dressing with water proof tape told no need to change it for 3 days. but I noticed some water discharge from it and dressing turned into yellow and it started smelling today. I have appointment tomorrow. what are the reasons for water discharge and smell as I can’t change dressing.

  37. I have an old wound that has opened up and I stepped on staples a few weeks back unfortunately I now have two wounds draining,,one of which smells….my Doctor is treating these wounds with nitrate oxide,,,,or dry ice… for a quick growing callus…the one is an old wound and will not heal,, are we on the right track??

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