Is Slough Considered Drainage? Clarifying Wound Assessment Terminology
Is slough considered drainage?
The Quick Answer
No—**slough is necrotic tissue**, not drainage. Drainage (exudate) is liquid fluid *leaving* the wound. Slough is solid, adherent material *within* the wound bed. During debridement, liquefied slough may mix with exudate, creating confusion—but assessment must distinguish tissue type (slough) from fluid output (drainage) for proper treatment selection.
Why We Ask This
Nurses and caregivers misclassify liquefying slough as 'increased drainage,' leading to inappropriate dressing choices (e.g., absorptive dressings for slough removal instead of hydrogels for autolysis)—delaying effective debridement.
The Practical Science
Wound assessment frameworks like TIME (Tissue, Infection, Moisture, Edge) categorize slough under 'T' (non-viable tissue) and drainage under 'M' (moisture balance). Slough requires debridement; drainage requires moisture management—distinct clinical actions.
In Clinical Practice
When slough liquefies during autolytic debridement, the wound may show increased yellow fluid—but probing reveals underlying stringy tissue. Correct documentation: '50% slough with moderate serosanguinous drainage' guides dressing selection toward debridement-focused products.
References & Context
Wound Assessment and Treatment and Tissue Types: Slough Versus ..."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.Feb 18, 2021"