Purulent Drainage

What is purulent drainage?

Purulent (pronounced “PYUR-uh-luhnt”) drainage (pus or exudate) is a symptom of infection. This thick, milky fluid oozes from a wound that isn’t healing properly. It contains a mixture of dead cells and bacteria, as well as white blood cells, which rush to the site at the first sign of injury.

Pus from an infected wound might be white, yellow, green, pink or brown in color — and it usually smells bad. Changes in purulent drainage color or odor usually mean the infection is getting worse.

Your skin is a protective barrier. Any time it breaks — whether from injury or surgery — you’ll see blood and watery clear or tinted fluids (serous drainage) around the wound. Serous drainage is normal — a sign of your body’s innate healing power. These fluids carry proteins and white blood cells to your wound to jumpstart the recovery process.

But if you notice thick, milky pus coming from your wound instead, it probably means you have an infection — and it’s important to tell a healthcare provider right away. Treating purulent drainage quickly can reduce your risk for serious (and sometimes, life-threatening) conditions like sepsis.

What are the most common causes of purulent drainage?

Infection causes purulent drainage. It happens when germs get inside your skin through a wound or surgical cut and spread into surrounding tissues. Bacterial infections are by far the most common cause of purulent drainage. But viral and fungal infections can also cause pus to form in a wound.

Anyone can develop purulent drainage. It can happen even with diligent wound or incision care, and it doesn’t mean you’ve done something wrong. Many factors can contribute to the development of pus. For example, you might be more likely to get purulent drainage if you:

• Are immunocompromised.
• Smoke.
• Have a wound that’s deep, large or jagged.
• Got a wound from a dirty or contaminated object.
• Have a bite from an animal or human.
• Have obesity.

How is purulent drainage treated?

Your provider will consider these factors when determining how to manage purulent drainage:

• Type of wound.
• Location of the infection in your body.
• How long it’s been since your initial surgery or injury.
• Your specific medical needs.

The first goal of treatment is to address the underlying cause of infection and prevent further drainage. The second goal is to balance the moisture around your wound and keep the skin around it healthy while you heal. To do this, your provider may use a wide range of absorbent dressings and bandages made from things like collagens and hydrocolloids. These materials help maintain a moist healing environment and encourage new tissue growth.

In addition to using dressings, providers use a variety of approaches when treating purulent drainage, like:

• Antibiotics. These medications are often a first-line treatment for purulent drainage. But your provider might run lab tests first to confirm that the infection is bacterial in nature. The results can also help them determine which antibiotic will be most effective. (If you have a viral or fungal infection, your provider may consider antivirals or antifungals as part of your treatment.)
• Negative pressure wound therapy. This treatment uses a pump and suction tubing to pull fluid away from the wound.
• Incision and drainage (I and D). Providers sometimes use this minor surgical procedure to drain an abscess (pocket of pus) from a wound.

How can I treat purulent drainage at home?

Your healthcare provider will show you how to clean and dress your wound properly at home. They can give you dressing materials and detailed instructions to help.

If you have an infected wound, it’s important to schedule an appointment with a healthcare provider. Don’t try to treat it at home. Here are some tips for keeping your wound clean in the meantime:

• Wash the skin around your wound thoroughly with antibacterial soap and water.
• Use clean tweezers to remove any dirt or debris in the wound.
• Use an antiseptic solution to clean your skin.
• Apply an over-the-counter antibacterial ointment to the skin around your wound.

What are the possible complications of not treating purulent drainage?

Left untreated, a wound with purulent drainage can turn into a chronic wound (also called a non-healing wound). This refers to a wound that doesn’t heal within eight weeks. This type of infection can spread to other areas of your body, causing increased pain and a range of health complications, including:

• Cellulitis (skin infection).
• Osteomyelitis (bone infection).
• Septicemia (blood infection).
• Sepsis (a potentially life-threatening inflammatory response).

Can purulent drainage be prevented?

The best way to reduce your risk of purulent drainage is to clean and dress your wound properly. Ask your healthcare provider how to do this. If you notice thick, milky or foul-smelling pus draining from your wound, tell your provider immediately.

Additionally, be sure to visit a healthcare provider for any medical conditions that increase your risk of infection.

When should I see a healthcare provider?

You should let your healthcare provider know any time you have concerns about wound healing. Schedule an appointment if you have:

• Increased skin discoloration, soreness or heat around a wound.
• Purulent wound drainage (thick or milky pus).
• Drainage that changes color or texture.
• A foul smell coming from your wound.
• A wound that hasn’t gone away.