The "white fluff" on your wound is most likely slough, a natural part of the healing process made of dead cells and protein. However, it could also be a sign of maceration, an infection, or healthy new tissue (granulation/epithelial tissue), so you should consult a healthcare professional for a proper assessment.
Purulent drainage refers to thick, milky discharge that comes out of a wound. It usually means you have infection, so it's important to get prompt medical care. Treatment can prevent cellulitis (skin infection), osteomyelitis (bone infection) and other serious conditions like sepsis.
Definition Slough consists of dead cells in the wound bed and is yellow/white in colour. It generally has a soft texture, it can be thick and adheres to the wound bed or patchy over the surface of the wound.
Removal of slough is a key step in promoting wound healing. The clinician needs to have a comprehensive understanding of what slough is, the impact on wound healing, and the various approaches that can be taken.
Slough refers to the yellow/white material in the wound bed; it is usually wet, but can be dry, and generally has a soft texture. It can be thick and adhered to the wound bed, present as a thin coating, or patchy over the surface of the wound. Slough consists of dead cells that accumulate in the wound exudate.
Under the scab's protective surface, new tissue forms. The body repairs damaged blood vessels and the skin makes collagen (a kind of tough, white protein fiber) to reconnect the broken tissue. When the work of healing is done, the scab dries up and falls off, leaving behind the repaired skin and, often, a scar.
Unlike the firm, dry appearance of black eschar or the healthy red granulation tissue, slough often has an uneven, irregular surface. It can range from pale yellow to deeper amber colors depending on the underlying cause.
Don't use abrasive or rough washcloths for skin care and wound healing. Don't scratch dry, itching areas. Scratching can cause further skin damage and increase the risk of infection, which can impede the healing process. Don't apply tape of any kind to dry, sensitive, fragile skin.
Slough will always show signs of stringy textures, yellow coloring, and will be more granular after cleansing. Purulence will always emit an odor after cleansing and will show signs of infection and erythema.
As debridement is implemented, the slough liquefies or dissolves and is (sometimes slowly) removed from the wound bed. However, as slough liquefies, the drainage may be confused with purulent drainage, depending on the nurse's assessment and experience.
Fluff gauze is there to cushion and protect wound areas. They are made out of a woven gauze material that is absorbent and fast-wicking. As a primary dressing, the design will allow for superior aeration and great absorbency. As a secondary dressing, they provide you with cushioning, bulk and conformability.
Don't rub or scrub the wound
This can cause the skin around it to become raw or irritated, which will make healing more difficult. Instead, gently pat away any dirt, lint, or other debris from your wound with clean tissue paper so it doesn't get trapped under the bandage.
Do not touch the wound. If the dressing is stuck, soak with water or saline and wait for the dressing to loosen – allow a bit of time and avoid pulling as this will be painful and will damage the wound. If the dressing is adhesive or has an adhesive border, avoid peeling it off.
Six signs that your wound is not healing
If a wound has eschar or slough present, collagenase will take approximately 2 weeks to destroy that tissue, assuming it is applied correctly and consistently.
A telltale sign of maceration is skin that looks soggy, feels soft, or appears whiter than usual. There may be a white ring around the wound in wounds that are too moist or have exposure to too much drainage. Most instances of maceration are mild and resolve on their own without medical intervention.
Signs of a wound infection
The skin around your wound is red or sore, or feels hot and swollen. Your wound has liquid (often green or yellow pus) coming out of it. Your wound opens. You feel generally unwell or have a temperature (fever).
Healthy granulation tissue is pink or red, with an uneven, mounded texture. These mounds are capillary loops or granulation buds. The formation of granulation tissue is thought to be an intermediate step in the healing process of full-thickness wounds.
Autolytic debridement is the natural process by which enzymes soften and liquefy devitalised tissues – a key component of the removal of slough by the body's own systems.
Yes, unless you have sutures (stitches), staples, exposed bone, or your doctor has advised against it. Make sure you ask before you shower or bathe. If you need to keep your wound dry, use a garbage bag or some sort of plastic cover to keep it dry when you shower. Typically, you should not be "soaking" your wound.
Eating well during wound healing helps you heal faster and fight infection. During healing your body needs more calories, protein, fluid, vitamin A, vitamin C, and zinc. The best source of these nutrients is food. If you are not eating enough healthy food, you may need to take a supplement.
Keep the dressing clean by changing it as often as you need. You can take it off after a few days, once the wound has closed.
Managing and removing slough from wounds is essential for promoting healing and preventing complications. Various debridement methods are employed to effectively remove necrotic tissue and facilitate the formation of healthy granulation tissue.
Slough Is Often Confused with Other Substances
Zinc, Vitamin A and Vitamin C aid in the creation of collagen for tissue repair and skin cell regeneration. Ensuring adequate intake of these key nutrients through a balanced diet or supplementation under the guidance of a healthcare professional can help support the wound healing process.