Following a mastectomy, a surgical procedure to remove breast tissue, patients often wake up with one or more thin tubes, known as surgical drains, placed near the incision site. These drains are a temporary but important part of the recovery process. They help manage the body’s natural response to surgery and facilitate healing.
Purpose of Drains
Surgical drains are used after a mastectomy to prevent fluid accumulation in the surgical area. When breast tissue is removed, a space is created where blood and lymphatic fluid can collect. If this fluid, called seroma, is not removed, it can lead to swelling, discomfort, delay healing, or increase infection risk.
The drains consist of a flexible tube inserted into the surgical site, connected to a small plastic bulb outside the body. This bulb creates suction, continuously drawing excess fluid away from the wound into the collection bulb. The tubing is secured to the skin with a stitch to keep it in place.
Determining Readiness for Removal
The decision to remove surgical drains is based on several factors, primarily the amount of fluid collected. Drains are considered ready for removal when fluid output consistently falls below a specific threshold. This typically means less than 25 to 30 milliliters (approximately two tablespoons) in a 24-hour period for two consecutive days.
The color and consistency of the drainage fluid also provide important clues about healing. Immediately after surgery, the fluid is often bloody and thick. Over several days, it should gradually become thinner and lighter, progressing from a thin red or pink to a straw-colored or clear appearance. Clear or straw-colored fluid indicates the body’s initial inflammatory response is subsiding, and the fluid is mostly lymphatic.
The absence of infection signs at the drain site is another important criterion. Medical professionals assess for symptoms like fever, increasing redness, significant swelling, warmth around the drain site, or foul-smelling or cloudy drainage. These signs indicate potential infection, requiring further evaluation before drain removal. Patient comfort and mobility can also play a minor role. The surgeon makes the final decision on drain removal, based on these factors and the patient’s healing progress.
The Removal Process
Surgical drain removal is a quick procedure, often performed by a nurse or doctor in an outpatient setting. The process involves a few steps. First, the medical professional cleans the area around the drain insertion site. The stitch holding the drain in place is then cut.
Following stitch removal, the drain tubing is gently and steadily pulled out from the surgical site. Patients commonly describe a pulling or tugging sensation, rather than severe pain. Most individuals do not require pain medication for the removal itself. After removal, a small gauze dressing is applied over the site. This dressing helps absorb any leakage and protects the area as the small opening closes, which typically happens within a few days.
Life After Drain Removal
Once surgical drains are removed, attention shifts to continued healing and monitoring. The drain site should be kept clean and dry to prevent complications. A small gauze bandage may be needed for about 24 hours to absorb any residual fluid leakage. Full healing of the drain site typically occurs within one to two weeks.
Despite drain removal, seroma recurrence is possible, where fluid collects again in the surgical area. Patients might notice new swelling, tenderness, or fluid accumulation under the skin. If this occurs, it is important to contact the surgeon, as larger or symptomatic seromas may need clinic drainage. Activity restrictions gradually ease, though heavy lifting and strenuous activities should still be avoided for several weeks to allow for complete internal healing. Patients should also monitor the surgical site for any infection signs, such as increased redness, warmth, pain, or unusual discharge, and report these to their medical team promptly.