Having
plastic surgery procedures sometimes calls for the use of drains. These drains
are used after the procedure is done to remove the build up of fluids that might
occur from a cavity left behind. If these fluids are allowed to build up, then
they can sometimes be the source of a
hematoma / seroma, of could possibly be
the source of infection. Some surgeons decide to place a drain in your incision
if there was excessive bleeding during the surgery.
Most plastic surgeons want their patients to record all of the drain output in
order to determine when they can safely be removed. The patient will be
responsible for emptying the drains at specific time periods (both morning and
evening) and be recorded. Most of the time the period of monitoring your output
in the drain is 12 hours at a time. The morning and the evening amounts are
added together to get the 24 hour total.
Drains are normally removed after
recording a 24 hour total with less than 40cc to 30cc for any particular drain. To
remove the fluid out of the drains, the
bulbs detach and you empty them and record the
drainage. When putting the bulbs back on the tubes, you will need to squeeze
them a bit to create suction. This suction helps with the drainage.
It is
not unusual to see clots, or pieces of tissue inside the tubing of the drain.
If they seem to be obstructing the drain’s flow, roll the tubing between your
fingers in an attempt to mobilize it. Any kind of flushing into the tubing
should never be done in attempt to clean it. The fluid that accumulates in the
drain should be pinkish brown in color.
If the
drain starts to come out, where the white portion of the tubing is showing, it
is safe to push it back in until the white portion no longer shows. The
important thing to remember is if the drain should accidentally fall out
completely, cover the site with gauze and call your Plastic Surgeon. You
should never try to push the drain back in.
Most patients are allowed to
shower with the drains, however if your plastic surgeon tells you not to get
this area wet at all, then you will need to do ‘sponge baths’ until you have
these removed. If you have been instructed not to get your drains wet, then
taking a sponge or a tub bath (with very little water), should be okay as long
as no water enters the surgical site.
Some drains can be long enough
to hang and lay on the floor, if not, it is suggested to wear a “belt” to pin
your drains to, in hopes of freeing up your hands for showering. These belts
can be made of a bathrobe belt, an old pants belt, or even a pair of pantyhose.
There are now, places that you can buy a "Drain Belt" that can help secure the
drains in a position so that you have freedom of your hands in a shower. Submerging the drains should
never be done in a bath, as contaminated water
could enter the surgical site.
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It is very important to take
all of your antibiotics that you have been prescribed. It is easy to get a
drain hole infected accidentally. Taking your prescribed medication will help
ward off any infection that might occur
The
longer the drain stays in, the
higher the chance of infection, so be sure to take your antibiotics as directed.
If you are having unusual thick discharge from the drain, please see the wound
chart located under post operative complications, “Infections”. Make sure you
call your surgeon with anything unusual.
Please see below Wound Chart if you suspect an infection:
Drains are normally called for in most patients who have abdominoplasty. The
purpose of the abdominoplasty drains is to decrease the risk of a seroma
forming. A seroma; is fluid that accumulates between the muscle layer and the
skin flap. Having a seroma can sometimes lead to a source of infection, so it
is very important to get all excess fluid out of this area as soon as
possible. Drains serve as a point of exit for this fluid accumulation, which
in turn will reduce the risks and complications that might arise from having
this procedure.
Even in abdomens
that look flat after abdominoplasty there is typically some amount of fluid
under the flaps, so having drains placed after surgery will help tremendously to
help rid the body of this fluid accumulation.
Tummy Tuck or
abdominoplasty drains are similar to the drains in breast surgery. The small
silicone tubes are inserted into the abdominal incision where the actual
procedure was performed, or the surgeon might make new tiny incisions
specifically for the drains.
The tubes on the drains are connected to bulbs that provide
suction for the excess fluid that accumulates during recovery. Most surgeons
ask the patient to monitor and measure the drainage each day. The drains can
sometimes only be used for the first three to five days after surgery, or it can
take up to several weeks to have these removed. Once you start noticing that
the drainage that is collected is not that much, then usually it is time to have
the drains removed.
As with breast surgery, you need to make sure the drains do not
become clogged. This can sometimes happen, and it is not unusual to see blood
clots of pieces of tissue inside the tubing of the drain. If the drain does
become clogged, then roll the tubing between your fingers in an attempt to
mobilize it. Avoid any kind of flushing of the tubing in the attempts to clean
it. Normal color of the fluid that is in the drain should be pinkish brown in
color. Your surgeon will be giving you instructions on how to care for the
drains during your recovery.
Any movement from the
waist should be kept to a minimum.
Do not make any
unnecessary up and down or twisting motions this will help to prevent any
build up of fluid.
Normally the drains should
have the fluid removed 2 to 3 times a day with the patient charting the time
and amount that was in the reservoir.
No lifting anything more
than 3 to 5 lbs. in weight after surgery.
As with any surgery,
make sure everything you will use is sterile and clean, do not use old
towels or sponges, buy new ones. This will minimizes the risks of getting
an infection.
