Surgical drains are tubes that are usually placed in the body after a surgical operation. The type that will be used in a given situation will be determined by the type of surgery that is being conducted. The kind of management that occurs in the immediate postoperative period is a huge determinant of whether or not the use of these devices will be successful. Every hospital needs to have clear written protocols on surgical drain management.
The general purpose of these tubes is to decompress cavities by allowing for the free flow of fluids. They prevent the accumulation of fluids such as pus, blood and serous fluids. The other important indication is that they help prevent accumulation of air (also known as dead space). Drains may also be inserted when there may be a need to characterize the fluid as the patient continues to recover.
The decision to have a drain is determined by the nature of the operation as well as surgeon preference. One of the surgical operations for which drain tubes are usually needed is breast surgery. There is a huge risk of fluid accumulation in the breast tissue after surgery and having a drain significantly reduces this risk. Orthopedic procedures particularly those in which joint cavities have to be opened also require tubes.
One of the classifications of drain tubes considers the tubes as being either open or closed. Open tubes include corrugated rubber and plastic sheets and typically direct the fluid onto a pad made of gauze or a stoma bag. This type is more prone to infections. The closed type is that which drains into a bottle or bag. This is the type preferred for orthopedic and chest operations.
Another form of classification is that of active and passive tubes. Active drain tubes are those that are connected to a suctioning force. Passive tubes, on the other hand, lack a suctioning force and solely rely on gravity. They require that the patient be placed on a surface above the ground so that the fluid can flow under gravity. The final method of classification is based on the material used (silicon or rubber).
Once the patient has been admitted to the ward after surgery, it is important to ensure that the tube is inspected regularly. The ideal time interval should be every four hours. During the inspections, look out for kinking or blockages, signs of infections and the type of fluid being drained. Passage of pus in a situation where there was none previously should be a warning sign that an infection has set in.
During the scheduled inspection rounds the state of the tube and the amount of fluid drained should be recorded. Suctioning is helpful in removing trapped fluid. The pressure needed for this has to be carefully prescribed as too much of it may cause injury to internal organs. There is a need to secure the tube so that it does not dislodge from its position.
The drain tubes will be removed when they have stopped functioning. In most centers, they will be removed if the 24 hour output is 25ml or less. The tube can be pulled out gently in one instance or can be removed slowly over time. The second option is said to aid in gradual healing of the insertion site. There may be associated pain or discomfort.
The general purpose of these tubes is to decompress cavities by allowing for the free flow of fluids. They prevent the accumulation of fluids such as pus, blood and serous fluids. The other important indication is that they help prevent accumulation of air (also known as dead space). Drains may also be inserted when there may be a need to characterize the fluid as the patient continues to recover.
The decision to have a drain is determined by the nature of the operation as well as surgeon preference. One of the surgical operations for which drain tubes are usually needed is breast surgery. There is a huge risk of fluid accumulation in the breast tissue after surgery and having a drain significantly reduces this risk. Orthopedic procedures particularly those in which joint cavities have to be opened also require tubes.
One of the classifications of drain tubes considers the tubes as being either open or closed. Open tubes include corrugated rubber and plastic sheets and typically direct the fluid onto a pad made of gauze or a stoma bag. This type is more prone to infections. The closed type is that which drains into a bottle or bag. This is the type preferred for orthopedic and chest operations.
Another form of classification is that of active and passive tubes. Active drain tubes are those that are connected to a suctioning force. Passive tubes, on the other hand, lack a suctioning force and solely rely on gravity. They require that the patient be placed on a surface above the ground so that the fluid can flow under gravity. The final method of classification is based on the material used (silicon or rubber).
Once the patient has been admitted to the ward after surgery, it is important to ensure that the tube is inspected regularly. The ideal time interval should be every four hours. During the inspections, look out for kinking or blockages, signs of infections and the type of fluid being drained. Passage of pus in a situation where there was none previously should be a warning sign that an infection has set in.
During the scheduled inspection rounds the state of the tube and the amount of fluid drained should be recorded. Suctioning is helpful in removing trapped fluid. The pressure needed for this has to be carefully prescribed as too much of it may cause injury to internal organs. There is a need to secure the tube so that it does not dislodge from its position.
The drain tubes will be removed when they have stopped functioning. In most centers, they will be removed if the 24 hour output is 25ml or less. The tube can be pulled out gently in one instance or can be removed slowly over time. The second option is said to aid in gradual healing of the insertion site. There may be associated pain or discomfort.
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