What is a drain?
A surgical drain is a small soft plastic tube placed into the wound during surgery. One (or two) tubes are used in order to remove any lymph fluid that collects after surgery. Part of the drain will stick out from your body and the end connected to a small plastic drainage bag that will collect any lymphatic fluid that has drained from your operation site.
Why do I need a drain?
The lymphatic system has been interrupted therefore can leak lymph fluid from the wound after surgery. If this fluid is not allowed to drain it can collect under the skin and potentially cause problems. This fluid collection is called a seroma.
The principal or main reasons for having a drain to remove this fluid are:
- To allow the wound to heal.
- To reduce pain, as the collection of fluid in a closed cavity can cause discomfort.
- To prevent a large collection of fluid as this is a potential site for infection.
How does the drain work?
Suction drainage works by gentle suction of fluid, which is collected in a bag. The colour and amount of fluid can be seen, which is important for the surgeon. As the area heals, the amount of drainage collected lessens until it is low enough for the drain to be removed.
Passive drainage relies on gravity to take fluid away without the extra suction. As the area heals, the amount of drainage collected lessens until it is low enough for the drain to be removed.
How to manage your drain
The drain has two locks: an upper lock (closer to your body) and a lower lock (closer to the collecting bag). Each lock can be in one of two positions: ‘Opened’ or ‘Closed’. The picture shows you how the drain will look when you leave the hopsital: the upper lock is ‘opened’ and the lower lock is ‘closed’. You will be shown how to use this before you go home.
The collapsible part between the two locks can become full or deflate. If this happens, you need to reactivate the drain by doing the following steps:
- Put the upper lock in the ‘closed’ position.
- Put the lower lock in the ‘opened’ position.
- Squeeze the collapsible part of the drain as shown
- While the collapsible part is still squeezed, put the lower lock in the ‘closed’ position.
- Put the upper lock in the ‘opened’ position.
- Record the amount on the chart.
- Measuring your drainage.
- You should always wash your hands with soap and water and dry them on a clean towel, both before and after measuring.
Measuring your drainage
You should always wash your hands with soap and water and dry them on a clean towel, both before and after measuring your drain.
You should measure the amount of drainage at roughly the same time every day.
- You should record the amount of fluid in the bag on page 6 of this booklet.
- When the drain shows less than 30ml, please contact the Skin Cancer team who will arrange for it to be removed.
Will I have a follow-up appointment?
Once your drain output is less than 30ml in 24 hours, and your surgical team consent, your drain will be removed. Drain removal will take place in the Plastics Dressings Clinics, Gate 24, Southmead Hospital.
How will the drain be removed?
The nurse will discuss the plan with you and gain your consent to do this procedure. Please ask the nurse if you have any questions or concerns.
The nurse will remove the vacuum from the drain and then remove the dressing and the stitch holding the drain in place. You will then be asked to take a deep breath as the drain is removed. The area will be covered with an absorbent dressing. The drain site may continue to leak until the area has completely healed. This will require a simple dressing.
Depending on the type of surgery you had, and your medical condition, you will still require follow-up appointments with your consultant’s team. Please check with your nurse if you are not sure when these are.
How long will I have the drain for?
This will depend on the type of surgery you have had and your individual circumstances.
Following plastic surgery, two drains are normally inserted under the skin near your surgery site. These can be in place for between 2-6 weeks after surgery.
Will I feel any pain?
You may feel discomfort around the drain site and may need medication to help ease this. Your surgeon will prescribe regular medication to reduce the pain. However, if you are in constant pain, or get new pain, you should contact a member of our team.
Stiffness can occur if you restrict your movement so gentle exercise is advisable. Walking short distances is good.
What are the risks?
In most cases there are very few complications, however you may experience:
Infection: an infection can occur around the entry of the drain site at any time following surgery and you may need treatment with antibiotics.
Seroma or collection of fluid at the wound site: there is a risk that fluid may collect beneath your stitch line. If this happens, a doctor may need to remove the fluid by another method and remove the drain.
What should I do if I have a problem?
Usually, patients who have been discharged with a drain do not have problems managing them at home. However, problems can sometimes occur so it’s important to know how to deal with them:
What if I accidentally remove the drain or it falls out?
The site may begin to leak or start bleeding slightly. Place a clean towel, or the gauze provided, over where the drain was and put pressure on the area for at least 15 minutes, or until the leakage/bleeding stops. When it stops, cover the hole with a clean plaster. Contact the hospital on the numbers provided.
What should I do if I think I have an infection?
Symptoms of infection include increased swelling, redness, tenderness, fluid leakage, an increase in your temperature and increased pain around the drain site, or if the site begins to swell. Please see medical attention immediately by contacting the Plastic Dressings clinic (Gate 24) or Clinical Nurse Specialist team during working hours or your GP.
What if the drain is blocked?
Do not panic. Sometimes clots of blood/tissue can appear in the tubing and will move along and end up in the drain. If you have any concerns, contact the Plastic Dressings clinic (during working hours) or the Clinical Nurse Specialist team.
Your GP practice nurse or visiting district nurses will also be able to assist or give advice.
When moving, you need to remember to pick the drain up and be careful not to get the tubing caught on any furniture to prevent it from being pulled out.
How to contact us:
Specialist Nurse Team:
NGS Macmillan Wellbeing Centre
0117 414 7415
If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice.
© North Bristol NHS Trust. This edition published March 2021. Review due March 2023. NBT003292