SURGICAL DRAINS

By: Delos Santos, Seidon C

Depnag, Kirsty
What are surgical drains?

 Surgical drain is a tube to remove blood, serum, lymph, and other

fluids that accumulate in the wound bed after a procedure.
 Prevent the collection of fluids that can lead to poor wound healing
and infections.
 Sometimes may have to be maintained for a long periods when
secretions are continuously being formed.
INDICATIONS:

 To prevent the accumulation of fluid (blood, pus and infected

fluids).
 To prevent accumulation of air (dead space).
 To characterise fluid (for example, early identification of
anastomotic leakage)
PRINCIPLES OF DRAINS:
 Must not be too rigid
 Must not be too soft
 Not of irritant material
 Wide bore enough to function
 Left for sufficient time so that when drain removed there is minimal
drainage
 Ensure the drain is secured
 Accurately measure and record drainage output.
 Monitor changes in character or volume of fluid
 Use measurements of fluid loss to assist intravenous replacement of
fluids.
TYPES OF DRAINS

 Open
 Closed
 Active
 Passive
OPEN DRAINS

 Include corrugated rubber or plastic sheets

 Drain fluids into a pack of gauze
 They increase the risk of infection
 E.g. Penrose drain
 Open: PENROSE DRAIN

 Made of soft rubber shaped into a tube

 Cut to the size of cavity to be drained
 Funcions by capillary drainage
CLOSED DRAIN

 Consists of tubes draining into a bottle or bag

 Is used in surgeries related to the chest, lungs and abdomen
 Prevents contaminants form entering the wound
ACTIVE DRAIN

 Maintained under suction

 May be in low or high pressure
 Not gravity dependent
 E.g. Jackson-Pratt drain
Active Drain: JACKSON-PRATT DRAIN

 Flexible plastic bulb that connects to an internal plastic drainage tube

 To produce a suction:
 Remove the cap of the bulb
 Squeeze the air out
 Replace cap
 Advantages
 Keep wound dry – efficient fluid removal
 Can be placed anywhere
 Prevent bacterial ascension
 Help appose skin to wound bed – quicker wound healing
 Allows evaluation of volume and nature of fluid
 Disadvantages
 High negative pressure may injure tissue
 Drain clogged by tissue
PASSIVE DRAIN

 Do not exert any pressure on the wound; have no suction

 Work according to the differential pressure between cavities and the
exterior
 Gravity dependent
 E.g. T-tube
Passive Drain: T-Tube

 A tube consisting of stem and a cross head

 Post-op drainge of the bile duct after cholecystectomy
 Stem is connected to a pouch
 Sometimes its used in ureteric problems too
 Advantages
 Allow evaluation of volume and nature of fluid
 Prevent bacterial ascension
 Eliminate dead space
 Help appose skin to wound bed – quicker wound healing
 Disadvantages
 Gravity dependent – affects location of drain
 Drain easily clogged
COMPLICATIONS:

 Inefficient drainage:
 Obstruction
 Poor drain selection (diameter too small to remove viscous
fluid)Erosion to hollow organs
 Erosion to hollow organs
 Incision dehiscence
 Poor placement
 Premature removal
 Accumuluation of fluid
REMOVAL OF DRAINS

 Generally, drains shoul be removed once the drainage has stopped or

becomes less than aout 25ml/day (removed in 12-24 hours)
 Drains can be shortened by withdrawing them gradually (typically 2cm
per day) and so, in theory, allowing the site to heal gradually.
 Consider the need for pain relief prior to removal
 Place a dry dressing over the site where the drain was removed.
THANK YOU!