May 22, 2018

The Ins and Outs of Surgical Drains

I recently had a surgery that followed another surgery I'd had just four weeks earlier - long story - and because of the extra care and difficulty of the second surgery, I had a surgical drain inserted for a little over two weeks.

Everything you need to know about surgical drains

My surgeon gave me a head up before the surgery that I'd wake up with a drain - thank goodness, or I would have been freaked out - so I looked up drains online before the surgery. I was disappointed to not find one good resource that answered all the main questions I had. Since I've now had experience with drains, I've decided to create that resource!

What You Need to Know About Surgical Drains


What is a surgical drain and what does it do?


A surgical drain is a thin plastic tube used after some surgeries. There are flat ones, known as JP drains, and round ones. I, fortunately, had the round one - the only type my surgeon uses, because they're much less painful to remove than the flat ones. They connect to a small plastic bag (or bulb, in my case) in which the fluid drains into.

Yes, that's a drain out of your body, removing fluid your surgeon doesn't want in you. That means it sticks out of you and will remain sticking out you until your surgeon removes it. It's very important, though, if your doctor requires it - it can prevent potentially dangerous complications like seromas and hematomas!

Where are surgical drains inserted?


The drain(s) will be inserted near your surgical site(s).

How long will you have your surgical drain in?


This varies a lot, based on your surgery and your needs. My doctor said I could get mine out once I'd been draining consistently under 30mL of fluid per day, with decreasing measurements each day, for three days. He also waited until the fluid had lightened in color - it starts bright red, when the surgical site is still really inflamed, and eventually becomes yellowish as it becomes just regular serous fluid.

For me, that was just a little over two weeks - I had my drain removed on the morning of the fifteenth day post surgery. My poor surgeon, I was constantly checking in to see if it could come out already!

Surgery Blog

Oops.

How do you care for a surgical drain?


Keep. It. Clean. Always wash your hands thoroughly before you empty the drain. 

To empty it, you'll uncap the bulb where the fluid collects, measure the fluid in a cup (if your surgeon instructs you to do so, as mine did), and then flush the fluid. Clean the cap and stopper of the bulb with an alcohol wipe, then squeeze the bulb in your palm, fold it in half, and reinsert the stopper in the cap. The bulb will then unfold on its own, but there will be suction in the bulb, creating suction in the drain, to suck that icky fluid out of you.

If you have a drain for a week or several weeks, it's possible that the drain will clog and you'll see a reduction in flow. If you ever see a big change in flow, whether it's an increase, decrease, or color change, let your surgeon know immediately. S/he'll probably instruct you to start stripping your drain, also known as 'milking the drain,' to keep things going. 

I had to strip my drain several times per day to keep the flow going. Basically, you pinch the top of the drain, very close to the insertion site, with one hand and then pinch just below that with the other hand and slide that down, all the way to the bulb. This forces anything in the tube into the bulb and reinforces the suction, so it can really get things going again.

Can you shower with a surgical drain?


While a surgical drain is there to prevent complications, if can raise the risk of one concerning complication - infection. After all, it's an opening in your body, through which fluids exit, but also through which bacteria can get in! 

Generally you'll be on strong antibiotics while you have the drains in as a preventative measure (I was for several weeks), but you'll also want to be as careful as possible. 

An incredibly accurate rendering of the antibiotics prescriptions my surgeon wrote for me. CVS pharmacists must be psychics.

Follow your surgeon's instructions to the letter - some will let you shower and some won't. Mine said that I could, but I didn't want to risk a third surgery so I just sponge bathed my body and then cleaned the insertion site daily with hydrogen peroxide, as instructed by my surgeon.

Even if you are allowed to shower and choose to do so, figuring out what to do with your drain while you're naked, unable to clip it to anything, and needing your hands for washing yourself, will require a bit of creativity and planning. You do not want your drain to just dangle freely!

How can you style a surgical drain?


The answer is that it's not easy. The bulb is pretty big and it can be hard to disguise. But there are few things that can help!

For starters, if your surgery is during cold months, you can pin the drain to your bra or a handy waistband, depending on where it's positioned, with a safety pin, so you're hands-free and able to move around freely. Hide that whole contraption under a bulky sweater and no one will be the wiser!

If your surgery isn't during the cold months, get a loose, billowy dress and clip it either to a belt around your waist, under your dress (there are special belts for this available online, google 'surgical drain belt' for plenty of options), or safety pin it to a sturdy pair of underwear. Either way, even under the billowy-est of dresses it's likely going to add some bulk. 

Being recently post-surgery and having a drain in is also an excellent excuse to avoid all the annoying people in your life.

Funny Dating Meme

That said, no one reasonable is going to comment on something that subtle about your body and most people won't notice, anyway. People don't scrutinize us as closely as we do ourselves.

I hope this helps someone!

Have you ever had surgical drains? What are your tips?

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