Instructions For Drain Care
Please note that immediately after your surgery, the color and consistency will be similar to blood. This is normal. As your surgical site heals over the next several days, the drainage will change colors. It can progress to a light pink, light yellow, or clear consistency. The drain will stay in place until less than 25 to 30 milliliters of fluid can be collected in a 24-hour period. This can take anywhere from 5 to 21 days, depending on the surgery. Everyones drainage is different.
Caring For Drains After Breast Reconstructionby Ravi Tandon Md On April 18 2019
Surgical drains are intended to prevent excessive accumulation of fluid after breast reconstruction. This reduces swelling and prevents seromas and other post-op complications. If you underwent a mastectomy before undergoing breast reconstruction surgery, you will be familiar with surgical drains, their use, and how to properly care for them.
Dr. Ravi Tandon would like to offer patients in the greater New Orleans, LA a brief overview of how to care for surgical drains after breast reconstruction surgery. We will provide more details on post-op healing and recovery during the consultation process.
Skill: Clearing Your Tubing And Emptying Your Drain
- If your hands are visibly dirty, wash your hands with soap and water for 15 to 30 seconds if your hands are not visibly dirty, use a 60% alcohol-based hand gel.
- Using one hand, firmly hold the tubing near where it comes out of the skin. This will prevent the drain from being pulled out while you are stripping it.
- Firmly pinch the tubing with your other hand, using your thumb and first finger. Squeeze the tubing and slowly slide your fingers down the tubing toward the drain. You may use an alcohol pad or apply lotion around the tubing to make it easier to slide your fingers down the tubing. Squeeze the tubing firmly enough that it becomes flat.
- To empty a closed suction drain, using a gloved hand, open the cap on the drain. Hold the opening pointed away from you and squeeze all of the drainage into a measuring cup or larger measuring container, if needed. Record the amount and color of the drainage. Call your doctor if the fluid is cloudy, bad smelling, or the amount of drainage has increased.
- To close the drain, hold the opening away from you and squeeze until the drain is as flat as possible. Then replace the cap.
- To discard the drainage, pour small amounts down the sink and flush the sink drain with hot water. Larger amounts of drainage can be poured into a toiletbe sure to close the cover when you flush to avoid spraying any drainage.
Practice Skill: Changing the Dressing around the Drain
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How Do I Track How Much Im Draining
The easiest way to track how much fluid you are draining is to use a log like the one below. You will be provided with a printout copy upon discharge.
What Not To Do With Surgical Drains After Breast Surgery
- Do not shower during the first 48 hours after surgery,
- Do not soak in a hot tub,
- Do not go swimming,
- Do not lift over ten pounds,
- Do not overexert yourself ,
- Do not let your pain become greater than a six on the pain scale .
Common concerns for women with breast surgery drains include:
- ShoweringYou will be able to shower normally with your drains.
- SleepingYour drains will be placed so they are unlikely to interfere with your sleep. If you tend to move around a lot in your sleep, you may want to sleep in a recliner to prevent accidentally pulling your drains out at night.
- ClothingYou should wear comfortable, loose-fitting clothing or a special drain management garment .
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How Do You Shower With A Drain Tube
You may shower after you remove the bandage but dont take a tub bath or submerge the area in water until your incision is completely closed and there is no drainage. Wash the site gently with soap and rinse the area with warm water. Pat the area dry.
What is a surgical drain and what does it do?
Surgical Drains. 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 should a surgeon do after removing a drain tube?
The surgical fellow should order an immediate X-ray of the drain tube site. The patient should be prepared for theatre, inform the parents and consider the need to keep the child nil by mouth in anticipation for surgical removal of the remaining drain tube.
How is a drainage tube attached to the skin?
Your doctor then attaches the tube to a drainage bag. They might make a couple of stitches in the skin to hold it in place. You have a dressing over the tube which also helps to keep it in position. You might only need to have the tube in for a few hours.
S To Empty Measure And Record Drainage
- Wash your hands thoroughly before emptying the drains.
- While the bulb is squeezed flat, strip the tubing with an alcohol swab or wet paper towel as shown below. This will help get all of the liquid into the bulb and move clots through the tubing to keep the drainage flowing. Pinch the tubing close to where it enters your skin in order to prevent tugging, which can be painful. Strip the tubing 2 or 3 times before you empty the drain.
- Pull the plug out of the bulb to release suction.
- Turn the bulb upside down and gently squeeze it to empty the fluid into a measuring cup as shown below. Clean the plug with alcohol. Then squeeze the bulb tightly until completely compressed and flat. While the bulb is flat, put the plug back into the bulb.
- The bulb should stay flat after it is plugged. This way the gentle and constant vacuum suction can restart.
- Measure the amount of fluid you collected in milliliters . Write the amount of drainage and the color as well as the date and time you collected it as shown below. Record these on the attached “Drain Log“.
- Flush the fluid down the toilet.
- Wash your hands.
- Keep your insertion site clean and dry by washing it with soap and water and patting it dry.
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What If There Is No Fluid To Empty From The Drain
Some of the reasons why there may not be any drainage include:
- The drainage bulb has lost its suction.
- The drainage tubing is blocked.
- There is no more fluid to drain.
To create suction in the bulb, try opening the plug on the bulb and re-closing the plug while squeezing the bulb with your hand.
- The nurses in the hospital will show you how to do this.
How Do I Milk The Drain
To stop the tubing from getting blocked, you will need to “milk the drain.”
- “Milking the drain” will clear the tubing of fluid, tissue and clots so that the drain continues to work properly.
- You will need to “milk” the drain every 3 to 4 hours only while you are awake.
- Be sure when “milking” to hold the tube firmly closest to the skin.
- A family member may be able to help you.
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When Should Drain Tubes Be Removed
Generally, drains should be removed once the drainage has stopped or becomes less than about 25 ml/day.
What happens if a surgical drain is removed too soon?
If they are removed too early you could get a build-up of fluid around your operation site. If they are left in for too long, there is an increased risk of infection. Will you feel any pain? You may feel discomfort around the drain site and may need pain medication to help ease this.
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.
Be sure to ask your physician what the optimal output is, so that you can alert the staff to get the drains removed. You may want them out sooner than they can, so just be patient. We get it. This part isnt easy, but you just got through a mastectomy surgery and you are strong!
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Caring For Your Skin After Drain Removal
- Your drain will be removed in the office and a dressing will be placed over the former drain site. Remove this dressing two days after drain removal.
- Do not take a bath or submerge the area in water until 4 to 6 weeks after your surgery.
- Wash the former drain site gently with soap and rinse the area with warm water. Gently pat the area dry. It is important to keep your insertion site and the area around it clean and dry as this will help prevent infection and promote healing of your skin.
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Do I Need Drain Tubes After A Breast Reduction Surgery
There are certain postoperative protocols that need to be followed after different types of surgical procedures to avoid complications or ensure a fast recovery, and breast reduction surgery is no different. One of the questions I often hear from patients desiring to undergo the procedure is whether they will need drain tubes after the procedure. Some of them see it as an unnecessary complication, and they ask if we can avoid this. Well, the reality is that drain tubes are used exactly to avoid other complications. They dont complicate things on their own.
In todays article, we will discuss about the need for drain tubes and other post-op indications after a breast reduction surgery.
Why Are They Necessary
Fluid tends to accumulate in the cavity left by breast tissue removal, similar to how serous fluid leaks from a burn wound. If it isn’t removed, it can cause discomfort and impede healing. Drains also decrease the risk of seroma, a cyst-like buildup that can be tender or painful and sometimes cause scarring.
“After surgery, your body may make extra fluid as part of the healing process. If the fluid is not removed with the drain, the fluid can build up,” said Lisa F. Schneider, M.D., a plastic and reconstructive surgeon who lives in New Jersey. “This can cause a number of different problems, including a fluid collection, which can require a second surgery to correct, or an infection of the fluid, which can make you sick.”
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How Long Does A Drain Tube Stay In After Surgery
The amount of serosanguineous fluid should decrease each day and the color of the fluid will turn light pink or light yellow. 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 is a drain used for after surgery?
A closed suction drain is used to remove fluids that build up in areas of your body after surgery or when you have an infection. Although there is more than one brand of closed suction drains, this drain is often called a Jackson-Pratt, or JP, drain. The drain is made up of two parts: A thin rubber tube.
How are drains used in post-operative surgery?
Introduction. 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, how much drainage is expected and surgeon preference.
What Does The Breast Reduction Surgery Involve
The breast reduction procedure is mostly performed on patients under general anesthesia as it can take up to 4 or 5 hours, depending on the complexity of the case. When a significant amount of mammary gland tissue needs to be removed, the procedure is lengthier as it takes some time to reshape and re center the breasts after excision to avoid asymmetries.
The procedure involves the surgical excision of a smaller or larger part of the mammary gland, the skin tissue under the areolas, and the afferent fat layer. At the same time, because the excessive development of the breasts often has, as a result, expanded the areolar tissue, the plastic surgeon might also need to reduce the size of the areolas and reposition them.
Breast reduction surgery can be performed using different techniques that will be decided during the pre-operative consultation. The patient needs to know about the method chosen to reduce the size of the breasts as the scarring will be determined by this.
An often-performed mammary reduction technique is the one that leaves behind an anchor or an inverted T shape scar with an incision around the areolas as well. Three incisions are needed in this case: one is circularly performed around the areola, another one goes from the areolas edge towards the inframammary fold in a vertical line, and the third one is positioned in the inframammary fold, horizontally.
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Transportation Lodging Child Care And Elder Care Assistance
You may not live near the hospital where youll have your surgery.
Sometimes, there are programs that help with local or long-distance transportation and lodging. Some also offer transportation and lodging for a friend or family member going with you.
There are also programs to help you with child and elder care costs.
SUSAN G. KOMEN® SUPPORT RESOURCES
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How Drains Can Delay Surgery Recovery
- Insertion and extraction of drain tube may lead to infections and/or unwanted bleeding at surgical sites
- Delayed skin recovery can also compromise results
- This may frustrate patients wanting to return to exercising as quickly as possible
- Research supports that routine drain use CAN be avoided by using advanced techniques
- So, I focus on techniques that provide greater comfort and reduced infection risks