Thursday, July 7, 2016

All You Need To Know About Surgical Drain Management

By Brenda Morris


Basically, surgical drains are tubes which are placed close to the incision after a surgical operation. These drains are intended to remove blood, pus or other fluid, in order to prevent it from accumulating in the body. The drainage system inserted is usually based on the type of surgery, needs of the patient, type of the wound, expected drainage as well as surgeon preference. However, surgical drain management is essential in order to prevent infections.

For a number of years, drains have become useful in various operations with good intentions. The general intention is decompressing or draining either air or the fluid away from the surgical spot. Therefore, these drains aid in preventing the accumulation of air, fluids or dead space and too, in characterizing the fluid, for example in early anastomotic leak detection.

Surgical drains are of different types. First, they can either be open or closed drains. Open drains includes plastic sheets or corrugated rubber and they drain the fluid into a stoma bag or a gauze pad. The open drains increases the chances of an infection. On the other hand, closed drains are made of tubes which drains into a bottle or a bag. Examples of this drains are orthopedics, chest, and abdominal drains. With closed drains, chances of infections are reduced.

Another type of surgical drain is the active and passive drains. The active drains are usually maintained through a suction that could either be high or low pressure. The passive drains do not have suction and normally works according to the pressure difference that exist between the exterior and the body cavities.

The drains can also be silastic or rubber drains. The silastic drains induces minimal tissue reaction since they are relatively inert. However, rubber drains can stimulate intense tissue reaction and in some cases, they can allow tracts to form.

Management of drains is usually governed by the purpose as well as the location of the drain. Therefore, preferences and instructions of the surgeon should be followed. The drain must remain secured since dislodgment can occur when transferring the patient. Such dislodgement may increase irritation and risk of infection. At the same time, changes in volume and the character of the fluid should be monitored. This is in order to identify arising complications that can result in leaking blood or fluid, especially pancreatic or bile secretions. Also, fluid loss should be measured to help in the intravenous replacement of lost fluids.

The drains should be removed after the drainage goes below 25 ml/day or has stopped. The drains can also be shortened by removing them gradually allowing gradual healing of the site. Some discomfort may be felt when the drains are pulled out raising the need for pain relief before they are removed.

When the drains are finally taken out a dry dressing needs to be put on the healing wound. A bit of drainage may still occur at the site until the wound is completely healed. Drains that are left for extended periods could be tough when removing, as early removal will lessen possible difficulties particularly infections.




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