Did you also have a surgical drain inserted after surgery? Let's talk about this!

You may have seen a small drain inserted into your body after surgery, or you may have had one yourself. It can feel a bit uncomfortable, right? But don't worry, this is a very important thing that will help your wound heal faster and reduce complications. So today, let's talk a little more about this surgical drain.

What is a surgical drain?

Simply put, a surgical drain is a small device used to drain fluids from your surgical site, that is, your wound. After surgery, as the wound heals, fluids such as cell debris, some blood, and water will leak out. If these collect inside the wound, it can delay healing and sometimes lead to infections. So this drain is placed to drain those fluids and help the wound heal faster. If taken care of properly, it can also greatly reduce the risk of infection.

While you have this tube in place, you will need to keep a record of how much fluid comes out each day and what color it is. This information will help your doctor understand how the wound is healing and when to remove the tube. It can also help detect any problems, such as infection, early.

Yes, having this tube in your mouth will feel a little strange and uncomfortable. It will take some time to get used to it. But remember, this is a very important part of your healing process, and it is temporary. Even if it doesn't seem like it now, this surgical tube will speed up your healing.

When is a surgical drain needed?

Surgeons insert these tubes after various types of surgery. Depending on the surgery you had, a tube may be inserted for these reasons:

• Stop fluid from accumulating inside a wound.
• Drain pus or infected fluid.
• Prevent blood from accumulating inside the wound (hematoma).
• Prevent accumulation of clear fluid (seroma).

The doctor inserts this tube while you are unconscious, that is, under anesthesia. So you don't feel it when it is inserted.

How do these surgical drains work?

All tubes drain fluids from the wound, such as blood and lymph, out of the body. However, the way this is done varies depending on the type of tube.

• Open drainage systems: These have a tube that is open on one side. One end of the tube is placed inside the wound, and the fluid coming out of the other end is collected in a piece of gauze that is applied to your skin. Gravity pulls the fluid out of the wound and into the gauze. A `Penrose drain` is one such open system.

• Closed drainage / suction systems: These have one end inside the wound, and the other end is attached to a small container that is designed to collect fluid. The air pressure created by squeezing the container draws fluid from the wound and collects it in the container. `Jackson-Pratt (JP) drains` and `Hemovac drains` are examples of such closed systems.

What are the main types of surgical drains?

Surgical instruments come in many different brands and models, but most surgeons use three main types:

1. Jackson-Pratt (JP) tube: This is a long, flexible tube. At one end is a small bulb-shaped collection container. The other end of the tube is inserted into the wound. The bulb side faces away from the body. When this bulb is squeezed, it draws fluid from the wound. This `JP drain` is the most commonly used type of surgical tube.

2. Penrose tube: A Penrose drain is a soft, flexible tube with two ends. When one end is inserted into the wound, fluid drains into it. Since the other end is protruding from the wound, fluid drains out. This fluid collects on a piece of gauze placed on the skin.

3. Hemovac tube: A `Hemovac drain` works in a similar way to a `JP drain`. However, instead of a bulb in the container where the fluid collects, it is a flexible cylindrical tube. It draws fluid in when squeezed. It can collect more fluid than a `JP drain`.

What problems can arise from surgical drains?

The benefits of having a surgical catheter placed far outweigh the potential complications. However, there are a few things you should be aware of:

• There is a risk of infection.
• The area where the tube enters the skin may be itchy and red .
• The tube can accidentally come loose, leak fluid, or become blocked .

But don't worry! Many of these problems can be prevented by keeping the wound clean and following your doctor's instructions carefully. If you have any questions about how to care for your tube, be sure to ask your doctor or nurse.

How do I take care of my drain?

Your medical team will give you instructions on how to care for your wound and the tubes you have inserted. These instructions may vary depending on the type of surgery you had and the type of tubes you have inserted. You should follow these instructions carefully.

Generally, caring for a wound means keeping it clean and free of infection. You will need to change the dressing regularly, remove any fluid that collects in closed-system drains, and record any fluid that comes out.

How to change the bandage in an open drain system

Your doctor will tell you how often to change the bandage (usually a piece of gauze) and whether to clean the wound. It is best to care for the wound near a sink where you can wash your hands. Always wash your hands thoroughly and clean them before handling the bandage and before touching the wound.

1. Wash your hands thoroughly with soap and water (or use an alcohol-based sanitizer). Use a towel to turn off the tap.

2. Remove the old bandage and throw it away.

3. Wash your hands again and put on a pair of clean (non-sterile) gloves.

4. Wash the wound frequently with soap and water or a wound cleanser.

5. Pat the skin dry with a clean towel.

6. Place the new bandage over the wound. The way you do this may vary slightly depending on the type of tube you have.

How to remove liquid from closed system drains

In closed systems, as the container that holds the liquid fills up, the amount of liquid it can draw from it decreases. That's why you need to remove the liquid from it regularly. Empty the container when it's about half full.

1. Wash your hands thoroughly.

2. With your non-dominant hand, hold the tube about a finger's length from where it enters the wound. Hold it firmly. This will prevent the tube from pulling on the wound during the next step and causing pain.

3. With your dominant hand, grab the tube below the point where you are holding it, and push the liquid inside the tube into the container.

4. Remove the stopper from the collection container and empty the liquid into a measuring cup.

5. Once empty, squeeze the container while putting the cap back on. This final step is what creates air pressure inside the tube and draws the liquid out.

Keeping notes about liquids (color and quantity)

You should also keep track of the fluid that comes out, i.e. what it looks like. As the wound heals, the fluid changes color. It can be blood-colored (sanguineous), blood-and-clear fluid (serosanguineous), and finally clear (serous - often yellowish). This color change is a sign that you are healing:

• Dark red (lots of blood)
• Light red or pink (mixed with blood and clear fluid)
• Light yellow (straw-colored) or clear (very clear liquid)

You should also note how much fluid you lose. A decrease in fluid loss day by day is also a sign that you are getting better.

• If it is a Penrose drain, write down when the bandage was changed and how wet the gauze was.
• If it's a `JP drain` or `Hemovac`, write down the time the tube was emptied and how much fluid was in the collection container. Look at the amount in the measuring cup and write down the amount.

How long should surgical drains be kept in place?

It depends on the type of surgery you had, the amount of fluid you're draining, and a few other things. Some people may need to stay in the tube for 24 hours or less, while others may need to stay in the tube for up to five weeks.

As the wound heals, the amount of fluid coming out should gradually decrease. Keeping track of how much fluid you are losing will help your doctor know when it is best to remove the tube.

Before you leave the hospital, ask your doctor how long you will need to stay on the tube.

How to remove a surgical drain

You may feel some discomfort or a pulling sensation when the doctor removes the surgical tube. It is usually removed as follows:

1. The doctor cleans the area with an antiseptic.

2. Cut the suture that is attached to the wound.

3. The priest will pull the tube out. At this point, you may feel a pulling or squeezing sensation.

4. Finally, if there is any bleeding, cover it with a bandage to stop it.

There will be a small hole in your skin where the tube was. It may take several weeks for it to heal completely, and you may even have a small scar where the tube was.

When should I see my doctor?

If you see these signs of infection, see your doctor immediately:

• If the fever is 100.4 degrees Fahrenheit (38 Celsius) or higher.
• If the wound area is red, swollen, warm, or painful .
• If you see red streaks at the wound site.
• If the fluid coming from the wound smells bad, is green, or is thick .

Also, if the tube is not working, or if you see any signs of other complications, call immediately:

• If your stitches are loose.
• If the tube comes out of the wound.
• If the amount of fluid coming out continues to increase for two days (it should decrease).
• If the fluid has been pink, light yellow, or clear, and then turns red again (this is a sign of bleeding).
• If there is a closed system drain, fluid has started to come out of the wound incision.
• In a closed system, if the liquid suddenly stops being drawn from the pipe.

If you have any doubts about whether you are taking proper care of your wound or tube, be sure to ask your doctor. It is always better to be safe than sorry and avoid getting an infection.

Finally, remember (Take-Home Message)

Although it may feel uncomfortable and uncomfortable at times, a surgical drain is just one step towards your full recovery. Before you leave the hospital, your medical team will explain how to care for the drain. When they do, don't hesitate to ask questions. Once you get home, make taking care of the drain and wound part of your daily routine. Give it to your doctor, and keep a careful record of the fluid that comes out. Wishing you a speedy recovery!

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