Surgical Drains After Breast Surgery And What You Need To Know To Prevent Infection
If you are having a mastectomy for breast cancer treatment of prophylaxis, you will most likely have surgical drains in place when you go home. Surgical drains are also usually placed during breast reconstruction surgery. Your surgeon or nurse will give you instructions on how to manage your drains, but knowing what to expect can make living with drains a bit easier.
Signs And Symptoms Of Infection
Having drains provides bacteria an access route to your body, and the longer drains are in place, the greater the risk of infection.
Signs of a drain-related infection may include:
- A fever with a temperature of 101 degrees F or higher
- Redness of your skin surrounding the drain
- Hardness or firmness where the drain exits your body
- Thickening rather than thinning of the drained liquid
- Foul smelling drainage or pus at the entry site
- Pain or discomfort at your drain sites
- A sudden change in the smell or color of the drainage
Breast Cancer Now Forum
- Float this Topic for Current User
Thanks for the cushion and drain dolly advice . Ive just read about these on Julia Bradburys Twitter feed too. Have just ordered a big heart cushion from cancer research website, because I got one in the post a few days ago and its lovely and soft.
I will get extra pillows ready. Wish Id ordered a new chair for downstairs now as mine have no head support so my head drops to the side if I doze there. I suppose its trying to sleep where you can. It sounds as though the first few days are the most difficult so need to prepare for that. My BC team have been downplaying it, saying it will be similar to my lumpectomy. Dont see how because its a much bigger op !
Getting scared now, but need this doing asap!!
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Slowing Drainage At Home
Consider Sleeping In A Lift Chair
I had direct-to-implant reconstruction at the same time as my mastectomy, which is less invasive than autologous, or flap, reconstruction. But Beth DeLong, 36, a breast cancer survivor and founder of Adventure After Cancer, who had DIEP flap breast reconstruction , required a more involved sleep setup when she was recovering from surgery. For the first two weeks after surgery, she slept in a lift chair, which she borrowed from a friend. You can rent a lift chair from a local medical supply company if you find you need it.
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Tips For Mastectomy Recovery:
Rent A Hospital Bed For Mastectomy Recovery
I rented a hospital bed for my recovery, says a breast cancer survivor. None of our recliners were comfy at all, plus I couldnt reach the controls. And I couldnt get out of our Tempurpedic bed without using my arms. She put a memory-foam topper and mattress pad on the hospital mattress, raised up the back and raised it up under the knees so she could sleep on her back. She was surprised at how comfortable it was, as sleeping on her back is usually very uncomfortable because of other health conditions.
She added that getting in and out of bed was so easy. She just lowered her knees, raised the back all the way up, and lowered the whole bed if needed. She even made her own bed while recovering from her mastectomy by raising it all the way up.
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Surgical Drain Care After Breast Surgery
You will need to regularly empty the bulbs attached to the tubes and write down the amount of fluid during your recovery. At home, you will:
- empty drains into the toilet when they become half full ,
- note the color and consistency of the drainage,
- rinse the empty bulb with water,
- gently compress the bulb to create a vacuum,
- close the tubing system by resecuring the bulb to the tubing.
Before you leave the hospital, a nurse will show you how to do these procedures. At home, have someone help you with the process if possible.
Be careful not to catch your drainage tubing on something and accidentally pull it out. Remember to place commonly used items within easy reach or ask someone for help with everyday tasks.
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 To Care For Surgical Drains
When you wake up from surgery, your recovery room nurse will probably warn you that you need to be careful with your drains. Depending on the length of the tubes , it’s easy to get these tangled up with IV lines, your bedclothes, and anything else nearby.
Your nurse will periodically drain your bulbs and show you how it’s done. He or she will log the amount of drainage from each tube, and you will be instructed to continue the log on your own until your drains are removed.
Before you leave the hospital, your healthcare team will review drain management, tell you about symptoms that should prompt you to call, and schedule a follow-up visit to have them removed.
When To Contact Us
Contact us for the following problems, any unanswered questions and emotional support needs. Call 353-7070 and ask to speak with a nurse during the day, or the answering service in the evening to reach your doctor or the doctor on call.
- Pain that is not relieved by medication
- Fever more than 100 degrees Fahrenheit or chills
- Excessive bleeding, such as a bloody dressing
- Excessive swelling
- Discharge or bad odor from the wound
- Allergic or other reactions to medication
- Anxiety, depression, trouble sleeping, need more support
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How Much Drainage Is Too Much After Mastectomy
When the drainage is over 30% of the original volume, we recommend that the drain be removed as early as possible after 3 weeks. Drainage should be performed in a well-ventilated area, with the patient lying supine. The patient should not be placed on a backboard or placed in an upright position, as this may increase the risk of aspiration of gastric contents into the abdominal cavity.
When Do You Remove Jp Drain
The drain should be emptied as often as possible so that the bulb can be compressed fully to maintain suction. In general, this is usually done every four to six hours the first few days until the amount decreases. The drain should remain in place until your doctor tells you it is okay to be removed.
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How Long Do Drain Tubes Stay In After Breast Surgery
When the fluid output reaches a low level, the drain should be left in. For two consecutive days, this is less than 30cc per day. One to three weeks after breast surgery is when most drains are removed. If your drain has been removed, you will be able to see the drain in the operating room. If you have any questions, please contact your surgeon.
When To Call Your Doctor
You should call your surgeon if you have any concerns or questions at all, or if you develop any of the following problems:
- If your drainage is bright red for more than two or three days
- If you develop any signs or symptoms of an infection as noted above
- If a large amount of fluid is leaking from where the drain tubing is inserted into the surgical site
- If your drainage output suddenly decreases or stops abruptly
- If your drainage becomes thicker rather than thinner as time goes on
- If your bulb loses suction
- If your drain falls out
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Plan To Sleep On Your Back After The Mastectomy
I surrounded myself with pillows on both sides, which cushioned me nicely, said a patient after breast cancer surgery. Also, for a few nights, my husband slept in the other room so as to avoid accidentally bumping me in the night.
Mastectomy Recovery Sleep Pillow
Contours Back Wedge With Massage Sleep Pillow will help if you dont naturally sleep on your back. This sleep pillow has a two-layer-design: it is made of 1 memory foam top layer plus a firm base foam for better comfort. Its more expensive to manufacture a bed pillow like this, but it offers more benefits. You get the more comfortable, soft feel of the cushion with a firm base foam that provides support. This pillow helps you stay in the same sleeping position all night, which will help with mastectomy recovery and sleeping after surgery. It also helps with acid reflux, snoring, poor circulation, back or neck problems, allergies or any other condition which breathing may be impaired when youre lying down. This pillow isnt just for breast cancer recovery you might find yourself using it long after the mastectomy is but a hazy dream! Or nightmare.
Drains & Expanders Explained
During my procedure, the surgical oncologist made an incision underneath the fold of my breasts and removed every bit of tissue in my chest. During this same time the reconstructive surgeon sewed in pockets of surgical mesh between my skin and chest muscle to hold tissue expanders. A breast tissue expander is an inflatable breast implant designed to stretch the skin and muscle to make room for a future, more permanent implant.
The reconstructive surgeon then sewed in 4 surgical drains. These drains consist of a small plastic reservoir bulb connected to about 4 feet of flexible drainage tubing. So I had 4 drains hanging out of my chest that were about 3 feet long each. Their purpose was to remove fluid from the surgical wound through mild suction. Opinions on how long the drains should stay in vary from doctor to doctor.
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What Color Should Drainage Be After Sugery
After surgery, the fluid that you see in your drainage tubes will become thinner in consistency and lighter in color over time. It should follow this progression:
- bloody and thick,
- swelling of the surgical area, and
- foul-smelling drainage.
Infected drainage will look creamy or milky and smell bad. If you notice these signs, call your doctor right away.
Be Generous With The Pain Medication
This is a mastectomy recovery tip is from a breast cancer survivor, but I hesitated to include because I dont want to encourage dependence on drugs. That said, however, her followup advice makes a lot of sense
Do not short yourself on the pain meds, said one patient. You cannot heal if you are in substantial pain. Also, under-medicating your pain may lead to guarding of the sore areas and poor posture, which can, in turn, cause other problems. If youre worried about becoming dependent on pain medication which I would be take full dose that the doctors prescription allows.
The doctor will give you guidance on when you have the option to switch to an anti-inflammatory medication such as aspirin, ibuprofen, or naproxen. The reason that you need to wait a few days is because these drugs have anti-clotting properties, and you dont want the surgical sites to bleed.
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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.
If you feel something isnt right and you think you have a problem with your drain after your mastectomy, call your doctor immediately. Complications happen and there is always some level of risk in any surgery or procedure. The biggest risk could be infection and it is something to take very seriously.
Length Of Hospital Stay
Most people will stay in the hospital overnight after a mastectomy.
If breast reconstruction is done, the stay may be longer, depending on the type of reconstruction.
Discuss the expected length of stay with your surgeon, plastic surgeon and insurance company.
Learn more about insurance issues related to mastectomy and breast reconstruction.
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Front Button Nightgown Or Shirt
Due to the discomfort experienced around the breast tissue and pectoral muscles after breast surgery, surgeons generally advise that patients refrain from raising their arms for the first few weeks. For this reason, front-button nightgowns or shirts are also recommended.
In addition to this advice, breast surgery patients suggest purchasing a smooth satin nightgown for bedtime that moves seamlessly against sheets and wont get caught up in the lanyard drains or supporting pillows.
Emptying And Tracking Drainage
Always wash your hands before and after each measurement. Early on, you’ll likely have around 100 cc drainage per day, but this will steadily decrease. You may be asked to empty your drains two to four times daily, or whenever they become about half full.
Note the color and consistency of the drainage. Early on, it will be bright red, but this should change to a straw color after a few days. After emptying your bulb into the toilet, rinse it with water and gently compress it to make sure a vacuum is recreated when you close the system. It is very helpful to have someone assist you with draining your surgical bulbs, if possible.
If you notice an increase in the amount of fluid, think about what you have been doing that may be causing that.
Increased drainage may be a sign that you’ve been too active and need to take it easy for a few more days.
Keep the insertion site clean and dry by washing with soap and water and gently patting dry.
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How Painful Is Mastectomy Recovery
Its common to have pain or discomfort after a mastectomy. Because everyone experiences pain differently, the intensity and duration can vary between individuals.
Your surgeon may prescribe a pain medication to take after you leave the hospital. Try to have a loved one get the prescription filled when youre on your way home, so youll have it on hand if you need it.
Its important to take all pain medications exactly as prescribed. Acute pain from a mastectomy will gradually go away as you heal.
What To Expect After A Mastectomy
After a mastectomy , you will have some soreness in your chest, underarm and shoulder.
You will be numb across your chest . Unfortunately, this numbness usually doesnt go away. You may get some feeling back over time, but it will never be the same as before surgery.
If lymph nodes in the underarm area are removed during surgery, you may also have some numbness and a burning feeling under and behind your arm. Theres also some risk of lymphedema.
Lymphedema is a condition where fluid collects in the arm , causing it to swell.
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