Home Health nursing

Managing Exudate Improves Wound Care and Costs

This post first appeared on TheNursingSite.com on July 25, 2022.
This is a sponsored post written by me on behalf of
ALLEVYN LIFE from Smith+Nephew. All opinions are 100% mine.

The general population is aging, and the oldest segment (those over 80) is one of the fastest growing. This segment is also demanding more and better health care to help them remain active, healthy, and fit. This comes at a cost and the cost of health care continues to skyrocket. The challenge for nurses and other healthcare professionals is to meet patient needs and somehow manage or reduce the costs.

Skin care is an increasing challenge as people age as well. The skin is the largest organ in the body and is therefore susceptible to a variety of challenges and issues. One such challenge is that as skin ages, it thins and can become quite fragile. It also dries out faster and requires more moisturizing to remain soft and supple. Fragile, dry skin can rip and tear easily from the lightest touch.

Skin break down or injury
If the skin is injured or breaks down from friction, pressure, or other means, it can become infected and, in some cases, even lead to sepsis. Prevention is a necessity and one that nurses focus on in all areas of health care. Treatment of wounds, bedsores, ulcers, surgical wounds, and other skin issues become a priority in patient care to prevent further break down, infection, or sepsis. Using products that simplify treatments help reduce pain and anxiety for patients and improve their experience of care.

Injured skin signals the body to release fluid and leukocytes to move quickly to the site of the injury in response to local inflammation. This substance is called exudate. There are four types of exudates known as serous, sanguineous, serosanguineous, and purulent. The exudate is essential to the healing process. The body’s inflammatory response leads to the dilatation of blood vessels with increased permeability. This then results in the increased production of exudate.

Exudate management
To best promote wound healing, the exudate needs to be managed. In a small wound, this is far less complicated. However, in larger wounds, ulcers, or bedsores, increasing amounts of exudate can cause complications such as maceration which can further break down the skin and result in a larger, deeper wound with a chance for worsening infection.

Larger wounds and bedsores often require highly exudative wound care. The
exudate management is complex and can become quite costly if frequent dressing changes are required. The goal today is to manage and reduce the costs of health care. Frequent dressing changes can manage the exudate; however, exudate retention is a more cost-effective treatment. This also helps to reduce the burden on nurses in hospitals, clinics, and home health care. Patient satisfaction is increased because painful dressing changes are reduced, and wound healing is improved.

Over the years, many products have been brought to market to help promote exudate retention and wound healing. In my experience as a home health and hospice field nurse, I have tried them all. The most effective of these has been absorbent foam dressings which absorb and retain the exudate, protect and cushion the wound, and allow for increased healing.

The “Pink Foam Dressing”
One of these products, in my opinion, stands head and shoulders above the rest. Smith+Nephew's ALLEVYN LIFE Foam Dressing is the best. This is a silicone gel adhesive dressing with a super absorbent pad with a foam layer and lock away core. The outer layer is breathable and showerproof. It’s casually known as “the pink dressing” or the "
pink foam dressing" based on its soft pink color. Don’t let the softness of the color deceive. This product is a workhorse.

Not only is this ALLEVYN product extremely absorbent, but it also comes in a variety of sizes and shapes to fit all those difficult places such as the coccyx or the bend of a knee or elbow. The exudate remains locked away in the core of the foam dressing and it adheres! The adhesion is gentle and releases easily, but it stays on until you remove or reposition it. Please see the
Smith+Nephew website for full instructions for use and safety information.


Color change indicator
In addition, the outer edge of 
ALLEVYN dressing begins to change color as it absorbs the exudate signaling when the dressing is full or should be changed. Frequent monitoring should be done initially to determine how fast the dressing is absorbing the exudate as indicated by the change of color on the outer edge. This takes away the guessing game and the temptation to change the dressing more often than necessary. Consider changing the dressing when 50% of the color change is evident, but it can be left until 75% is color changed at the discretion of the nurse. How often the dressing should be checked should be reevaluated at each dressing change.

The ALLEVYN dressing is designed to remain in place up to 7 days (5 days in the sacral area) depending on the condition of the wound. As opposed to daily or BID dressing changes, this drastically reduces the cost of the product as well as the nurse’s time.

Should the exudate suddenly increase, the nurse will be able to note this on routine rounds, the patient can be taught to alert the nurse if the location is visible, or the CNA or home health aide can also check when bathing or assisting the patient and notify the nurse. This can greatly reduce the nurse’s time while allowing for improved wound healing. Of course, any new or increased symptoms such as redness, swelling, pain, discomfort, or odor emanating should be evaluated immediately.

View the color change indicator media on TheNursingSite.com

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