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Sanguineous Drainage

What Is It, Appearance, and More

Author: Anna Hernández, MD

Editors: Ahaana Singh, Józia McGowan, DO, FACOI, FNAOME, CS

Illustrator: Jillian Dunbar

Copyeditor: Joy Mapes


What is sanguineous drainage?

Sanguineous drainage refers to the leakage of fresh blood produced by an open wound. This type of drainage is more commonly seen in wounds that extend beyond the superficial layers of the skin, such as deep wounds of full and partial thickness, which are typically associated with blood vessel damage.

A drainage, or exudate, is a fluid produced by the body in response to tissue damage. Most wounds produce a certain amount of exudate as part of the wound healing process, but the nature and quantity of the exudate depend on the severity of the tissue damage, as well as the presence of any underlying complications.

In addition to sanguineous drainage, other common types of wound drainage include serous, serosanguineous, and purulent drainage. Serous drainage is a thin, watery fluid that is produced in response to local inflammation. A small amount of serous drainage is essential for the healing process. However, experiencing large amounts of serous exudate may indicate a high bioburden, which relates to an abundance of germs living on the surface of the wound. Serosanguineous drainage, a mixture of serous and sanguineous drainage, is the most common type of exudate seen in wounds. Finally, purulent drainage is usually seen in infected wounds, and it is composed of a build up of white blood cells, dead bacteria, and damaged cells.

Understanding the different types of wound drainage can help assess the state of a wound and choose the best wound care regimen for each injury. 

What causes sanguineous drainage?

Sanguineous drainage is typically produced in the first stages of the wound-healing process, which include hemostasis, or the stage when a clot is formed, and the inflammatory stage. During the inflammatory stage, damaged cells release inflammatory molecules that make nearby blood vessels become more leaky or permeable, attracting immune cells to the site of injury. Producing a small amount of sanguineous drainage during this stage is part of the natural healing process. However, when sanguineous drainage appears in later stages of the healing process, it may indicate that a wound has reopened or undergone some kind of trauma. Notably, wounds are very fragile and especially vulnerable to any kind of injury during the first week or so of healing. 

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What color is sanguineous drainage?

Sanguineous drainage is composed primarily of fresh blood, so it is bright red in color and has a syrup-like consistency. As blood begins to clot, the exudate turns to a deep red color. When the clot has dried out, it develops into a scab, which serves as the body’s barrier to help keep germs and small dirt particles out of the wound. 

What is the difference between sanguineous and serosanguineous drainage?

Unlike sanguineous drainage, serosanguineous drainage is a thin, watery fluid that is pink in color due to the presence of a small amount of red blood cells. It is mainly composed of plasma (i.e., the non-cellular portion of blood), which contains proteins, immune cells, and other inflammatory molecules that are essential for the healing process. Although serosanguineous drainage can appear in healthy, healing wounds, it is usually indicative of damage to capillaries, which are the smallest blood vessels of the body. The tiny capillaries that lie close to the skin’s surface can easily be injured by minor trauma, such as when a bandage or dressing is removed.

What are the most important facts to know about sanguineous drainage?

Sanguineous drainage refers to the leakage of fresh blood from an open wound. This type of drainage is bright red in color and has a syrup-like consistency. It usually appears during the inflammatory stage of the healing process, during which a small amount of blood may leak from deep wounds of full or partial thickness. If sanguineous drainage occurs outside of the inflammatory stage, it may be a sign that a wound has reopened or undergone some kind of trauma.

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Related links

Skin anatomy and physiology
Wound healing
Burns
Integumentary: Applying dressings and bandages (for nursing assistant training)

Resources for research and reference

Adderley, U. (2010). Managing wound exudate and promoting healing. British Journal of Community Nursing, 15(3), S15-S20. DOI: 10.12968/bjcn.2010.15.sup1.46907 

Cutting, K. (2003). Wound exudate: Composition and functions. British Journal of Community Nursing, 8(9 Suppl), S4-S9. DOI: 10.12968/bjcn.2003.8.sup3.11577 

Potter, P., Perry, A., Stockert, P., & Hall, A. (2021). Fundamentals of nursing (10th ed.). Elsevier.