Surgical Drains: Types, Management, and Care Protocols

Surgical Drains: Definition and Purpose

Drains are medical devices used for the evacuation of fluids from a surgical wound or cavity.

1. Isobaric (Passive) Drains

In surgical wounds of moderate size and uncomplicated nature, the doctor places a drain to evacuate fluids to the exterior via gravity.

• Penrose: A soft latex tube available in various sizes and diameters.
• Cigarette: Similar to a Penrose drain but contains gauze inside.
• Teja (Canopy): A soft, flexible sheet of rubber.
• Kehr (T-Tube): A silicone rubber or T-shaped tube.
• Silastic Tube.
• Jackson-Pratt (JP) Tube.

2. Hypobaric (Suction) Drains

These are closed systems that utilize a vacuum to suction secretions.

• Redon Drain: The most common type, consisting of a PVC or silicone tube with holes at the end inserted into the wound. It connects to a crystal or plastic container or a bellows-shaped device.
• Saratoga T-Tube: A model featuring an air intake.

Note: The primary risk associated with drainage is the potential entry of microorganisms.

Complications

• Drain malfunction or displacement.
• Infection.
• Inflammation of the wound.
• Hemorrhage.
• Necrosis.
• Evisceration and incisional hernia.

Jackson-Pratt (JP) Drain Care

The JP drain consists of a bulb-shaped reservoir with a thin rubber tube inserted into the wound. It may remain in place for weeks, sometimes requiring the patient to manage it at home.

How to Maintain the JP Drain

1. Wash your hands.
2. Remove the plug from the bulb.
3. Empty the discharge into a measuring cup.
4. Dispose of the fluid and wash your hands.
5. Squeeze the bulb to create a vacuum and replace the plug.
6. Record the date, time, and amount of secretion three times daily.
7. If the bulb loses compression, open the plug, re-compress, and close it again.

When to Contact Your Doctor

• Swelling, redness, or discharge around the tube site.
• Inability to crush the bulb after emptying.
• The bulb is dropped or the tube becomes dislodged.
• Presence of fever.

Nursing Care and Best Practices

• Fixation: Ensure the drain is securely fixed.
• Permeability: Maintain drainage flow by avoiding kinks and disconnections.
• Monitoring: Observe the nature and quantity of the drained liquid.
• Asepsis: Protect the site from infection using aseptic techniques.
• Positioning: Do not lift drains above the wound level to prevent reflux.