Heavily exuding wounds can cause discomfort to the patient as well as inhibiting healing and causing peri-wound maceration. The cost implications of managing heavily exuding wounds create concerns for both clinicians and budget managers. The clinician must examine both clinical and cost-effective means of exudate management. The Exsudex™ wound drainage device offers an alternative to the many absorbent dressings on the market for managing heavily exuding wounds by using topical negative pressure to encourage healing. This article discusses its effectiveness using case studies to illustrate its use.