The period following a mastectomy requires focused attention on recovery, and restorative sleep is a major component of this healing process. Surgical drains are tubes inserted to remove excess fluid (seroma) from the surgical site. These drains consist of flexible tubing connected to a compressible bulb that creates a gentle vacuum to pull fluid away from the healing tissue. While these devices prevent fluid accumulation and support recovery, their presence significantly challenges finding a safe and comfortable sleeping position.
Safe and Comfortable Sleep Positions
The primary recommended posture for sleeping with mastectomy drains is the supine, or back-sleeping, position. This orientation minimizes direct pressure on the surgical incisions and the delicate drain insertion sites. Lying on the back significantly reduces the risk of accidentally pulling the tubing or displacing a drain.
It is crucial to avoid sleeping on your stomach or side while the drains are present. These positions cause the body’s weight to press down on the tubes or the surgical area, potentially causing pain or damage to the healing tissue. Rolling onto a side can pull the drain tube taut, risking sharp pain at the incision site or accidental removal of the device.
To transition into and out of the back-sleeping position without straining the chest or arm muscles, use a specific technique. Instead of sitting straight up, roll slightly to one side. Use the elbow of the non-surgical arm to push the torso up while swinging the legs off the bed simultaneously. This log-rolling motion prevents the use of the healing pectoral muscles, protecting them from excessive strain.
Essential Bedding and Support Equipment
Achieving comfortable back sleep often requires elevating the upper body, typically to an angle between 35 and 45 degrees. A wedge pillow system is highly effective, providing a firm, gradual incline that supports the entire torso and prevents slumping. This elevation aids in reducing post-surgical swelling and leverages gravity to promote the optimal function of the surgical drains.
Standard pillows should be strategically placed to ensure the arms and shoulders are fully supported. Placing a pillow underneath each arm, raising the hand above the heart, helps reduce swelling and prevents the arms from falling back, which can cause pulling sensations on the chest muscles. Placing another pillow under the knees can help alleviate pressure on the lower back, a common complaint when sleeping elevated.
Specialized recovery garments, such as post-mastectomy camisoles, function as essential support equipment during the night. These garments often feature built-in pouches or pockets sized to hold the drain bulbs securely against the body. This prevents the bulbs from swinging freely, which can lead to accidental snagging or uncomfortable tugging on the tubing.
Managing and Securing Drainage Tubes
Before settling in for the night, the drainage tubes and bulbs must be managed to ensure safety and function. The most reliable method for securing the bulbs is to use a drain management belt or a specialized camisole with integrated pockets. These accessories keep the bulbs contained and stable, significantly reducing the likelihood of the drains being pulled or accidentally disconnected.
If specialized garments are unavailable, the tubes can be secured by carefully safety-pinning them to loose-fitting pajamas or a cotton undershirt. Pin the tubing at a point that leaves sufficient slack between the pin and the insertion site. This allows for natural movements during sleep without creating tension on the incision, ensuring the weight of the collection bulb never pulls directly on the skin.
The drain bulb should be positioned lower than the surgical site to maintain the gentle downward flow of fluid, promoting continuous drainage. The tubing should be arranged so that it does not cross over or under the body, where it could easily become kinked or compressed. Before lying down, ensure the bulb is properly compressed to maintain the necessary vacuum suction for effective fluid removal.
Nighttime Safety and Emergency Guidance
Keep all necessary supplies within easy reach of the bed, minimizing the need to stretch or reach across the body. Supplies include pain medication, a phone, and a flashlight to check the drain bulbs and tubing if you wake up. The drain measurement log, which tracks fluid output, should also be kept close by for easy recording upon waking.
If waking up, quickly check the drainage system for signs of a problem. Ensure the tubes are not kinked, which would impede fluid flow, and that the bulbs remain fully compressed, indicating active suction. Any sudden, severe pain at the insertion site should prompt immediate attention, as this could indicate a pull or a potential issue with the drain.
Knowing when to contact a healthcare provider is a fundamental part of nighttime safety with surgical drains. Call your doctor immediately if:
- A drain is accidentally pulled out.
- There is a sudden, significant increase in fluid leakage around the insertion site.
- The drainage stops completely without prior reduction in output, suggesting a possible clog.
- A fever above 101°F occurs.
- There is excessive redness or swelling around the drain site.
- Any foul-smelling discharge is present, which may indicate an infection.