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What Is the Difference Between Serosanguinous and Sanguineous?

What Is the Difference Between Serosanguinous and Sanguineous
Serosanguinous drainage is thin discharge that contains a small amount of blood, while sanguineous drainage is fresh blood that leaks out of a wound

Serosanguinous and sanguineous drainage are two types of wound drainage, and each provide clues as to the extent of tissue damage:

  • Serosanguinous drainage: Thin discharge, with mainly edema fluid and almost no cells, that is seen in wounds during the healing phase. Discharge is usually thin, pink, and watery. When a wound is infected, the discharge thickens and appears as milky pus that is gray, green, or yellow. Serosanguinous drainage may also appear more red, indicating an active bleed, open wound, or hemorrhage.
  • Sanguineous drainage: Fresh blood that comes out of the wound that is normally seen during the inflammatory phase of wound healing. It reduces gradually with time and stops in most cases after a few hours. However, in deeper wounds, sanguineous wound drainage may remain for a few days even as the amount of drainage reduces significantly.

What causes serosanguinous and sanguineous drainage?

Serosanguinous drainage

Serosanguinous drainage is caused by damaged capillary lining, very common in wounds with vast surface areas that require dressings to be cleaned or changed.

Injuries that require frequent dressing changes may result in increased serosanguineous leakage when old drainage dries and sticks to the dressing or bandage. When the dressing is removed, it can injure capillaries near the skin, leading to drainage.

Sanguineous drainage

Sanguineous drainage is more common in wounds that extend beyond the skin's superficial layers, such as deep wounds of full and partial thickness, which are typically associated with blood vessel damage.

The wound may be reopened due to reinjury during the healing phase, resulting in sanguineous discharge.

Why is it important to know the difference between various wound drainages?

Wound discharge plays a major role in the healing process, as it contains immune cells that fight infections and growth factors that promote cell proliferation. Moreover, wound drainage provides cells with nutrition and stimulates enzymes in damaged cells that help with the healing process.

Characteristics of both serosanguinous and sanguineous drainage, such as volume, viscosity, color, and smell, can indicate the presence of bacteria and possible infection. This can help doctors determine a more effective treatment strategy for wound care.

What are the basics of wound care?

Wound care is based on several factors: 

Wound characteristics

It is essential to understand the extent of tissue damage and evaluate the amount of each type of tissue in the wound. A wound has two types of tissues:

  • Granulation tissue: 
    • New tissue that indicates wound healing:
    • Appears pinkish and contains several new blood vessels
    • Grows from the base of a wound and covers a wound of any size
    • Has a cobblestone appearance and is red
  • Necrotic tissue: 
    • Dead tissue that appears yellow, black or brown
    • Texture may be thick, leathery, dry, and hard or soft, moist, and loose
    • Often accompanied by a foul smell

Wound drainage

Wound drainage can help indicate the stage of healing and indicate the presence of contamination. Wounds with too much discharge and odor should be cleaned thoroughly, and frequent dressings are required.


An infected wound delays healing. If an infection is suspected, a culture should be performed to determine the type of bacteria that have colonized in the wound. Appropriate treatment with systemic antibiotics, cleaning the wound with saline water, and other topical antibacterial agents must be administered frequently to eliminate bacterial growth and promote healing.


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