Managing exudate and maceration in venous leg ulceration within the acute health setting

Exudate forms as a normal part of wound healing and develops during the initial inflammatory phase.¹ The body's response to a tissue injury results in the production of exudate as a result of neutrophils and other signalling molecules rushing to the site of injury, triggering the blood vessels to become porous and leak protein-rich fluid into the wound bed.¹ Exudate is vital in the wound healing process as it contains the messenger cells, growth factors and nutrients needed for the removal of non-viable tissue and the repair of damaged cells. It also creates the moist environment required for successful healing; however, the optimum balance of moisture is a very important factor in whether a wound will heal successfully or not, and varies dependent on wound type.¹

In acute wounds, this protein-rich fluid, known as ‘nature's balsam’ is beneficial; it washes the wound, acts as a transport medium for the cells and growth factors responsible for the healing process, and removes any residual debris and devitalised tissue to prepare the wound for healing.¹ As the wound progresses successfully through the healing process, the amount of exudate gradually diminishes and the moisture balance of not too wet and not too dry produces the ideal environment for healing.²