Managing exudate associated with venous leg ulceration.

This review highlights the challenges associated with highly exuding venous leg ulcers for both the patient and the clinician. The main focus of the author's article is the management of heavy exudate levels, and key to this is the assessment process, which is discussed. The wide range of products and treatments available for managing high exudate levels are also explored. Despite these options, patients continue to suffer distress and the indignities of soiling of clothes, social embarrassment and reduced quality of life. The definition and composition of exudate is given, with particular emphasis on the damaging effects of chronic wound exudate. Reasons for high exudate and the priority of treating the underlying cause are discussed. Common themes examined are the assessment process, treating the underlying aetiology, the use of dressings and skin care. Complications of poor exudate management include a negative effect on the patient's quality of life, wound bed and periwound damage, increased risk of infection, increased costs to the health service and a delay in healing (Vowden and Vowden, 2003). Primary research and reviews are summarised, evaluating their significance to the various themes explored.