… In fact, moist wounds heal 2–3 times faster than dry wounds (Swezey, 2014). Exudate is a normal part of healing; however, it can cause problems in the wrong amount, in the • wrong place or when of the wrong composition. … Although it is clear too much or insufficient exudate delays healing, there is no internationally • accepted standard method for measuring the rate of exudate production nor is there an accepted ‘normal’ rate Table 4: Published exudate production rates Wound type Method of exudate production measurement Rate of exudate production 2 (g/cm /24 hours) Leg ulcers Dressing weight (Dealey et al, 2006) 0.17–0.21 Dressing weight (Thomas et al, 1996) 0.43–0.63 Various Negative pressure wound therapy canister collection (Dealey et al, 2006) 1.3* Granulating wounds Vapour pressure gradient (evaporative water loss) 0.51 (Lamke et al, 1977) Skin donor sites Vapour pressure gradient (evaporative water loss) (Lamke et al, 1977) 0.42 Partial-thickness burns Evaporimeter (Ferguson et al, 1991) 0.42¬0.86 Vapour pressure gradient (evaporative water loss) (Lamke et al, 1977) 0.43 Full-thickness burns Vapour pressure gradient (evaporative water loss) (Lamke et al, 1977) 0.34 2 *Units: ml/cm /24 hours 8 EXUDATE-RELATED Wound exudate can delay healing, severely affecting a patient’s quality of life and producing CLINICAL PROBLEMS significant socioeconomic burden when: ■ The amount of the exudate is excessive or insufficient Box 2: Wound types that may and/or produce high or low levels ■ The composition of the exudate is abnormal of exudate (Bates-Jensen & and/or Ovington, 2007; Gardner, 2012; ■ The exudate is in the wrong place (Moore & Strapp, 2015). … Indeed, when protease activity in a wound is elevated, there is a 90% chance that the wound will not heal (Moore & Strapp, 2015). Furthermore, if the exudate comes into contact with periwound skin, it can damage the skin and even cause wound expansion (Wounds UK, 2013). 10 Figure 2: Periwound maceration Periwound skin damage (photograph courtesy of Dr Periwound skin damage includes maceration and erosions of the skin surface (Figure 2). …