Surgical drains are common medical devices used after various operations to manage fluid accumulation at the surgical site. These drains provide a controlled way to remove excess fluids that naturally gather in the body after tissue manipulation during surgery.
Understanding Surgical Drains
A surgical drain typically consists of a flexible tube inserted into the body near the surgical area, connected to an external collection device. Different types of drains are used depending on the surgery and expected fluid volume, but all aim to move fluid away from the healing tissues.
Common types include closed suction systems like the Jackson-Pratt (JP) drain and the Hemovac drain. A JP drain features a flexible tube connected to a lemon-shaped bulb, which, when compressed, creates a gentle vacuum to draw out fluid. Similarly, a Hemovac drain uses a collapsible cylindrical container to create suction. Open drainage systems, such as the Penrose drain, rely on gravity to allow fluid to seep onto an absorbent dressing.
Key Purposes of Surgical Drains
One primary reason for placing surgical drains is to prevent fluid accumulation within the surgical site. During an operation, tissues are often manipulated, creating spaces where blood, lymphatic fluid, and inflammatory fluids can collect. Drains actively remove this excess fluid, preventing the formation of fluid pockets that could cause swelling, pressure, and discomfort. These fluid collections can include seromas, which are clear, yellowish fluid buildups, or hematomas, which are collections of blood.
Removing these fluids also helps to reduce the risk of infection. Stagnant fluid at a surgical site can serve as a breeding ground for bacteria, potentially leading to complications. By continuously draining these fluids, surgical drains help maintain a cleaner environment, thereby lowering the chances of bacterial growth and subsequent infection.
What Happens Without Drains?
If a necessary surgical drain is not used or is removed prematurely, several issues can arise, primarily the buildup of fluid leading to seromas or hematomas. These can cause swelling, tenderness, and pain, delaying healing and potentially requiring further medical intervention. Untreated fluid accumulation also increases infection risk, as stagnant fluid provides an environment conducive to bacterial growth. In some instances, large seromas or hematomas might necessitate additional procedures, such as needle aspiration, to manually drain the fluid. The absence of proper drainage can prolong recovery time and potentially affect the aesthetic outcome of the surgery.
Managing Your Surgical Drain
Patients with surgical drains are typically provided with instructions for daily care to ensure proper function and minimize complications. This care often involves emptying the collection bulb or bag at regular intervals, usually when it is about halfway full, and measuring the fluid output. Recording the amount and color of the drainage helps healthcare providers monitor the healing process.
Maintaining hygiene around the drain site is also important to prevent infection; this includes washing hands thoroughly before and after handling the drain and cleaning the skin around the insertion site. Healthcare teams instruct patients on how to “milk” or “strip” the tubing, which involves gently squeezing and sliding fingers down the tube to prevent clots and ensure continuous drainage.
Drains are typically removed once the fluid output significantly decreases, often to less than 30 milliliters per day for two consecutive days. The removal process is generally quick and involves cutting a stitch that holds the drain in place, then gently pulling the tube out. Patients should contact their doctor if they experience fever, increased pain, significant redness, foul-smelling drainage, or if the drain stops working or becomes dislodged.