What indicates a complication during a dressing change?

The presence of purulent drainage from the wound is a strong indicator of a complication during a dressing change. Purulent drainage suggests that there is an infection occurring in the wound. In healthy, healing wounds, drainage is typically serous (clear or slightly yellowish) rather than purulent, which is thick and often cloudy or yellow/green due to the presence of pus. The appearance of purulent drainage can signal that further assessment, intervention, and possibly antimicrobial treatment are needed to address the infection and promote healing.

In contrast, other signs listed would generally indicate a wound that is healing appropriately. A dry dressing on the wound suggests that there may not be excessive drainage, and the dressing is intact, which is typically favorable. Incision edges that are approximated indicate proper healing and that there is no separation of the wound edges, which is also a positive sign. Clean surrounding tissue further supports the idea that there is no infection or complication, indicating that the area around the wound is healthy and not inflamed or infected. Thus, purulent drainage stands out as a clear complication needing attention during a dressing change.