Key Points
- A surgical drain is a tube that facilitates the removal of blood, pus, or other fluids from the operative site
- Indications for their insertion include the drainage of a potential space, monitoring of outputs, and the detection of bleeds or leaks
- Once inserted, its output should be monitored closely and only removed when determined appropriate by the surgical team
How long does a drain tube stay in after surgery?
Your surgeon will usually remove the bulb when drainage is below 25 ml per day for two days in a row. On average, JP drains can continue to drain for 1 to 5 weeks.
What surgery requires drain tubes?
Standard surgical procedures that require a drain:Chest pleural drainage.Chest surgery.Lymph node clearance procedure for malignancy.Breast surgery.Abdominal surgery.Thyroid surgery.Plastic surgery flap procedures.
What happens to fluid after surgical drain is removed?
Answer: Fluid after drain removal Your body will naturally absorb the drainage as long as it is not excessive and decreasing in production. If the fluid continues to accumulate, then you can develop a seroma (fluid collection).
When should post op drain be removed?
Care After Surgery (Drains)A drain is removed when the output is very low, usually <30 mL per day.Home drain care: If drain output is too high to be removed before leaving the hospital, a patient can go home with the drain left in place. ... After drain removal, cover the site with a Band-Aid or dressing for one day.More items...
When is a surgical drain needed?
After a surgery, fluid may collect inside your body in the surgical area. This makes an infection or other problems more likely. A surgical drain allows the fluid to flow out. The doctor puts a thin, flexible rubber tube into the area of your body where the fluid is likely to collect.
Does it hurt to have a drain tube removed?
– Is drain removal painful? Patients may experience a pulling or pressure sensation, however there is generally no pain experienced during drain removal. Drain removal takes only a few seconds. The stitch securing the drain in place is first removed followed by gentle removal of the drainage tube.
Why are my post surgical drains still producing?
Sometimes persistent drainage is related to excessive activity that prevents the skin flap from adhering to the underlying abdominal wall tissues. Sometimes there may be contamination or sub-clinical infection of the drain itself, which can cause persistent drainage.
What color should drainage be after surgery?
The color of the fluid usually begins as cranberry (blood tinged) and as the days after surgery go by, the color becomes pink or yellow. The more active you are, the more fluid will be produced. Sometimes increased activity can cause the color of the fluid to become cranberry after it has been yellow.
How much drainage is normal after surgery?
A mild amount of drainage from the incision is normal. If the drainage fluid is thin, watery, and pinkish red, there is likely nothing to be concerned about. However, there are instances in which you should be concerned about drainage from your incision.
What causes fluid build up after surgery?
Surgery causes damage to the blood and lymph vessels and surrounding tissue. An inflammatory response occurs, and the severed vessels and tissues will produce clear fluid in response. This is why there is pain and swelling after surgery. In some cases, the fluid forms a pocket, which leads to the formation of a seroma.
Can I remove my own surgical drain?
To remove the drain, remove any visible tape that may be securing the tubing to your skin or dressing. Gently pull the plastic tubing out. There may be slight discomfort but the tube should pull out easily. You should leave the rest of the bandage intact unless the physician has instructed you otherwise.
What does dark blood in drains mean?
Answer: Change in color of drainage A darker red color is normal. It's just older blood. After a few days it also may become almost clear. This is called serous drainage and is normal. http://www.cosmeticsurgerybaltimore.com/
Why do some surgeries require drains?
What are drains? Drains remove and collect blood, pus or other excess fluids that can collect inside your chest after Top Surgery. If fluids are given a chance to build up, complications and/or infection can set in and healing can be delayed. Excess fluid in a post-surgical site can also cause pain and swelling.
What are the four types of drainage?
These are dendritic, trellis, rectangular, and radial patterns.
What are the types of surgical drains?
Surgical drains can be broadly classified into:Jackson-Pratt drain - consists of a perforated round or flat tube connected to a negative pressure collection device. ... Blake drain - a round silicone tube with channels that carry fluid to a negative pressure collection device. ... Penrose drain - a soft rubber tube.More items...
What causes fluid build up after surgery?
Surgery causes damage to the blood and lymph vessels and surrounding tissue. An inflammatory response occurs, and the severed vessels and tissues will produce clear fluid in response. This is why there is pain and swelling after surgery. In some cases, the fluid forms a pocket, which leads to the formation of a seroma.
What is a drain tube?
A surgical drain is a small plastic tube that is sometimes used after an operation. It is put inside you during the surgery by the doctor and will stick out of your body until it is removed, usually a few days later.
What is a surgical drain?
Surgeons use small plastic tubes to help drain away fluid after an operation: without them the fluid might gather up and cause infection. Or, in the case of an operation on the lungs or chest, air might gather up and squash the lungs.
Why are surgical drains useful?
The armpit makes a lot of fluid after being operated on. Without a drain, the fluid might gather up in a large pool and be painful. The pressure of the fluid inside might stop the wound healing properly. So the surgical drain allows extra fluid to drain off harmlessly. A few days later, when the fluid production has faded away, the drain can be removed painlessly.
What is the procedure called when a drain comes out of the nose?
Operations on the stomach (the drain often then comes out your nose and is called a 'nasogastric tube'). Operations on the bladder (the drain then usually comes out the urine tube and is called a 'urinary catheter'). Your surgeon will discuss with you before the operation whether you will need a surgical drain and where it will be.
When will a surgeon discuss a drain?
Your surgeon will discuss with you before the operation whether you will need a surgical drain and where it will be.
Can a drain from your chest keep you in hospital?
They can keep you in hospital longer. Sometimes they can stop you moving around as much as you'd like, particularly if you have a drain from your chest area. If they are left in for too long accidentally, they can be difficult to pull out and may leave a small tract which will take a while to heal up.
What is penrose drain?
Penrose™ – flat ribbon-like drain, gauze is applied to external end to absorb drainage, can be colonised by bacteria if left in situ for an extended period of time.
What to do if drainage is minimal?
If drainage is minimal, ensure the drain is not blocked, if blocked, notify the treating team and AUM.
How to fix a leaky drain?
If leakage occurs at a surgical drain site, please notify the AUM and treating team and consider the following: 1 Reinforcing or retaping the surgical drain dressing 2 Placing a Coloplast™ drainage bag (2245) over the surgical drain tubing 3 Review the wound care nursing guideline for further information 4 Refer patient to Stomal Therapy for further input if necessary
How long should you give analgesia before a procedure?
If using analgesia ensure it is given 30-45 minutes prior to procedure to ensure it has taken peak effect. Please refer to the procedural pain management guideline for more information.
How to remove a drain from a septic system?
Using standard aseptic technique, clean around the site and remove any sutures. Pinching the edges of the skin together, rotate tubing from side to side gently to loosen, then remove the drain using a smooth, but fast, continuous traction. Tie off any purse-string sutures and apply occlusive dressing.
How to uncoil a pigtail drain?
To uncoil the pigtail drain the catheter/string should be cut to release the string that creates the pigtail coil. If required, cut the tip of the tube for cultures. Document removal of drain and that it is intact/not intact in progress notes as well as amount of drainage in the flowsheets.
What is a redivac drain?
Redivac™ – a high negative pressure drain used for larger draining amounts. Pigtail™ – Small lumen with a coil in the shape of a pigtail, used for draining a single cavity, passive drains, easily blocked (discuss with surgical registrar if safe to flush). Self retaining (no suture).
What is a surgical drain?
A surgical drain is placed to keep fluid or infectious material from building up at the site of your surgery. The drain does exactly what it sounds like: it drains fluid away and out of the body, just like a plumbing drain. A drain can be placed during surgery or as an outpatient procedure.
Why do you need a drain after a procedure?
You may have been told you that you will have a surgical drain in place after a procedure, or perhaps that you need to have a drain placed to help treat a collection of fluid or to treat an infection , such as an abscess .
How long does it take to drain a drain after surgery?
In many cases after surgery, it is safe to fully remove the drain when there is less than 30 cubic centimeters (1 ounce) of fluid being drained for two days, or when three weeks have passed. If you are still unsure when to remove a drain, ask your doctor or surgeon.
How long does it take for a drain to be removed after a syringe?
Generally speaking, a drain can be removed when there is less than 30 cubic centimeters (1 ounce) of fluid for two straight days or three weeks after surgery, whichever comes first. Having a drain removed usually does not hurt, but it can feel rather odd as the tubing slides out of the body.
What does it mean when a drain is bloody?
It is important to pay attention to the type and amount of drainage that is coming out, it may be bloody, a clear serous fluid, or it may be colored drainage that indicates infection. Abnormal types of drainage should be reported to your surgeon. 2 . Surgical Infections Can Be Easily Prevented.
How many drains are there for surgery?
The type of drain that is used depends on the type of surgery, the preference of the surgeon, and the site of the surgery. There may be one drain or several, depending on the nature of the problem.
Can a drain be removed without surgery?
Drains are designed to be removed without the need for further surgery or additional procedures. They may leave the body through the surgical incision, or a small incision may be made specifically for the drain itself. The drain may have sutures holding it in place to prevent it from being accidentally dislodged.
What drain system is used for breast surgery?
While there are different types of surgical drains, the type used most often for breast surgeries is the Jackson-Pratt drainage system. 2 These drains are placed within your surgical field ...
Why do surgeons put drains in the area?
Drains also reduce the chance that you will develop a seroma , a collection of fluid that can be uncomfortable and sometimes cause scarring. 1 For this reason, your surgeon will place drains in the regions where fluid is expected to accumulate.
What is the best drain for breast surgery?
While there are different types of surgical drains, the type used most often for breast surgeries is the Jackson-Pratt drainage system . 2 These drains are placed within your surgical field and are attached to flexible tubing that passes through and is stitched to your skin. The tubing is capped with a soft plastic bulb, which catches and holds the fluid, and a stopper outside of your body.
Why do breast drains work?
Surgical drains perform an important role in healing after breast surgery. Fluid often builds up in the area where a breast is removed and can cause discomfort and delay healing if it is not drained.
What are the problems with drains?
Problems that can occur with drains include: 1 Increased drainage: Some people note increased drainage if they are too active, while others don't find this to be the case. 2 Clots in the tubing: On occasion, patients will find a clot in their tubing. If this occurs, try gently kneading the area. 3 Loss of vacuum pressure: If a proper vacuum isn't created after emptying your bulb, your drain may fail to remove fluid. If this occurs, the build-up in fluid can be uncomfortable. 4 Infection: Drain site infections are not uncommon and are more likely the longer your drains are in place.
Why do drains need to be longer?
Having drains provides bacteria an access route to your body, and the longer drains are in place, the greater the risk of infection. 5
How to remove drains from a tubing?
Your surgeon will remove your drains by cutting the suture holding it in place and gently pulling out the tubing. You may notice a pulling sensation, but this only lasts a few minutes. Most people do not need any pain medications for this procedure.
What more should I know about drain care for my surgical sites?
If instructed by your doctor, you may shower with the drains in place. Attach them to an old belt or cloth strap to limit the amount of pulling on the skin and to avoid the risk of pulling the drain out accidentally.
What is a drain made of?
The drain is made up of a piece of tubing with a collection bulb at the end. It is possible for clots to form in the tubing and block the outflow of fluids. To prevent this, it will be important for you to "strip" or "milk" the tubing occasionally. To do this:
How to pinch off tubing?
Hold the tubing between your thumb and index finger at a point where the tubing exits the skin. Squeeze your fingers together to pinch off the tubing. Position the fingers of the other hand in the same way just below the pinched off tubing.
How to keep a tubing clear?
While holding the first 2 fingers in place to prevent pulling on your skin, slide the bottom 2 fingers down the tubing. This pushes any clots into the collection bulb. You might need to do this at several points down the tubing. Do 2 to 3 times a day to keep the tubing clear.
How long can a drain be left?
Also note: Drains are routinely not left in longer than 2 weeks but if you have questions about your specific case, call your surgeon.
How to empty a septic tank?
You might need to empty the drain 2 to 3 times a day (or more), depending on the amount of output. Here are your steps to do this: 1 To empty, lift the "pop top" on the collection bulb, and squeeze the fluid into a measuring cup with incremental markings (fl oz or cc). 2 Once empty, squeeze the bulb and put the "pop top" back in place to resume suction. If you drain 55 cc or more (as seen on the bulb markings), you may estimate the amount of fluid drained. 3 Record in your chart (see sample chart in next section) the amount of drainage, along with the time of the measurement.
How does a JP drain work?
You may have a stitch to hold the tube in place. The JP drain removes fluids by creating suction in the tube. The bulb is squeezed flat and connected to the tube that sticks out of your body. The bulb expands as it fills with fluid.
What is a JP drain?
The JP drain is a bulb-shaped device connected to a tube. One end of the tube is placed inside you during surgery. The other end comes out through a small cut in your skin. The bulb is connected to this end. You may have a stitch to hold the tube in place. The JP drain removes fluids by creating suction in the tube.
How long does it take for a JP drain to be removed?
The JP drain usually is removed when less than 30 milliliters (2 tablespoons) is collected in 24 hours. Ask your healthcare provider when and how your JP drain will be removed.
How to clean a JP drain?
Use soap and water or saline (salt water) solution to clean your JP drain site. Dip a cotton swab or gauze pad in the solution and gently clean your skin. Pat the area dry. Place a new bandage on your JP drain site and secure it to your skin with medical tape. Wash your hands.
How to clear Jackson Pratt tubing?
Use the following steps to clear your Jackson-Pratt tubing: Hold the tubing between your thumb and first finger at the place closest to your skin. This hand will prevent the tube from being pulled out of your skin. Use your other thumb and first finger to slide the clog down the tubing toward the bulb.
What Is The Purpose Of A Mastectomy Drain?
The purpose of post-mastectomy drains is to aid in the healing processes after the removal of breast tissue is completed. “The body often builds up fluid and can cause discomfort and delay healing if not drained,” says VeryWellHealth in an article explaining the science behind mastectomy drains and why they are needed to help heal.
Caring For Your Drain
Breast surgeons and plastic surgeons will give you a very extensive list of how to care for the drains. One task post-surgery will be managing the drainage output by how much fluid is building up in the bulbs. We won’t lie, this process can be a bit stomach twisting.
Living With Your Drain
Managing your drains through everyday activities may feel cumbersome, but we have some helpful tips to get you through.
Common Mastectomy Drain Problems
Common drain problems following a mastectomy could include risk of infection, issues with your incision site, or pressure loss in the drain.
When Should You Contact Your Doctor?
If you are experiencing an increase in your drainage output instead of a decrease,call your doctor. If you are experiencing heat, rash, or burning at your incision site of the drainage tube,call your doctor. If you have a loss of vacuum pressure in the drain,call your doctor.
How Are Mastectomy Drains Removed?
As a part of the recovery and follow-up process post-mastectomy, your doctor will make the final call of when it is time to remove the drains. Typically, they will base this decision off of the amount of fluid that is being produced day after day.
Want More Info On How To Manage Your Drains Post-Mastectomy?
We love the article “What to Expect” on BreastCancer.org and all their other supporting content. Vetted by medical professionals and written by an expert staff, there are tons and tons of helpful articles throughout the site to help you navigate a cancer diagnosis and all that comes with it.
What is surgical drain?
Classification of drains. Types of drains. Assessment. Complication of Drain. Removal of drain. summary. 3. Definition A surgical drain is a tube used to remove pus, blood or other fluids from a wound .
What drains are open?
7. Open drains Include corrugated rubber or plastic sheets . Drain fluid collects in gauze pad or stoma bag . They increase the risk of infection. E.g. Penrose drain. Closed drains Consist of tubes draining into a bag or bottle. They include chest and abdominal drains. The risk of infection is reduced. E.g. Jackson-pratt drain.
How does a JP drain work?
The bulb is connected to this end. The JP drain used as negative pressure vacuum, which also collects fluid. The JP drain removes fluids by creating suction in the tube. The bulb is squeezed flat and connected to the tube that sticks out of your body.
What does it mean when a drain is more than expected?
If a site drains more than expected, it may be a sign that fluid is continuing to accumulate, and a new drain may have to be placed. Managing drains is an important part of the postop healing process. With your knowledge and skill, you'll contribute to the best possible outcome. 32.
How to re-establish suction in a drainage bottle?
To re-establish suction, squeeze the rubber bulb with a continuous pumping motion until the balloon in the drainage bottle is completely inflated. Quickly replace the plug in the drain before the balloon deflates. The inflated balloon inside the drainage bottle creates the suction. 17.
What is a JP drain?
12. Jackson-pratt drain A Jackson-Pratt (JP) drain is used to remove fluids that build up in an area of the body after surgery. The JP drain is a bulb- shaped device connected to a tube. One end of the tube is placed inside body during surgery. The other end comes out through a small cut in the skin. The bulb is connected to this end. The JP drain used as negative pressure vacuum, which also collects fluid. The JP drain removes fluids by creating suction in the tube. The bulb is squeezed flat and connected to the tube that sticks out of your body. The bulb expands as it fills with fluid. Common uses: Abdominal surgery Breast surgery. Mastectomy. Thoracic surgery.
How long does it take for a drain to be in place?
Depending on the amount of drainage, a patient may have the drain in place one day to weeks. Drains are available in different size .
Introduction
Aim
Definition of Terms
Assessment
- Surgical drains are tubes placed near surgical incisions in the post-operative patient, to remove pus, blood or other fluid, preventing it from accumulating in the body. The type of drainage system inserted is based on the needs of patient, type of surgery, type of wound, amount of drainage expected and surgeon preference.
Troubleshooting
- This guideline is designed to ensure a standard approach to care and management of surgical drains (as listed below) through evidence based practice. Note:This guideline does not relate to the care and management of Chest Drains (UWSD) or drains inserted post cardiothoracic surgery. For further information on these drains please follow this link to Chest Drain Management Nursi…
Removal
- Jackson-Pratt™ – a soft pliable tube with multiple perforations and a bulb that can recreate low negative pressure vacuum, designed so that body tissues are not sucked into the tube, decreasing ris...
- Redivac™– a high negative pressure drain used for larger draining amounts.
- Pigtail™– Small lumen with a coil in the shape of a pigtail, used for draining a single cavity, p…
- Jackson-Pratt™ – a soft pliable tube with multiple perforations and a bulb that can recreate low negative pressure vacuum, designed so that body tissues are not sucked into the tube, decreasing ris...
- Redivac™– a high negative pressure drain used for larger draining amounts.
- Pigtail™– Small lumen with a coil in the shape of a pigtail, used for draining a single cavity, passive drains, easily blocked (discuss with surgical registrar if safe to flush). Self retaining (no...
- Penrose™ – flat ribbon-like drain, gauze is applied to external end to absorb drainage, can be colonised by bacteria if left in situ for an extended period of time.
Links
- Initial
Assess drain insertion site for signs of fluid or air leakage, redness or irritation to the skin. Document site condition and notify treating team and AUM if any concerns. Assess if drain is secured with suture or tape, document on LDAs. Assess patency of drain. Ensure drain is locate… - Ongoing
Monitor patient for signs of sepsis; if the patient is febrile, has redness, tenderness or increased ooze at the drain site, this could be a sign of infection, the treating team must be notified and blood cultures may need to be obtained. Drain patency and insertion site should be observed at t…