However, when the wound becomes ‘chronic’ and non-healing with persistent, abnormal inflammation or when infection becomes established, exudate takes on a different guise and generates clinical challenges.In the chronic wound, exudate contains proteolytic enzymes and other components not seen in acute wounds .In chronic wounds, the colour, consistency and amount of exudate may change as a result of various physiological processes  See Table 2. Some strains of Staphylococcus aureus, β-haemolytic group A streptococci and Bacteroides fragilis, produce fibrinolysins. This has been attributed in part to specific bacterial virulence mechanisms that result in vasodilation and extravasation .Pseudomonas aeruginosa produces a non-specific enzyme that degrades fibrin. Gautam et al (2001)  have described a process whereby neutrophils attracted to the site of injury trigger the release of heparin-binding protein (HBP).Zetuvit E pads consist of a non-adherent, non-woven, polypropylene material with an absorbent core.This gives a high-level of absorption and creates a barrier against contamination, getting your player back in the game.Wound exudate was described by the Swiss physician Paracelsus (c1491-1541) as nature’s balsam .It is derived from serum through the inflammatory/extravasation process.
It has a high protein content (although lower than that found in serum), with a specific gravity greater than 1.020.Certain bacteria such as Pseudomonas aeruginosa stimulate the release of HBP from neutrophils, thus aggravating chronic inflammation by augmenting endothelial hyper-permeability .Recent research has indicated that some bacteria actually express histamine and thus, if present, produce an additional physiological source of histamine in the wound environment. morganii Gram-negative rods have been found to express histamine .Bacteria isolated from chronic wounds have been found to produce physiologically significant levels of histamine  .It has yet to be determined if the production of this pro-inflammatory agent may be effectively managed through the application of antihistamines.