Surgical Drains

Fundamentals
1
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Overview

Surgical drains are inserted into a surgical wound bed to prevent excess
drainage from accumulating inside the wound tissues.
This also helps to prevent delayed healing.

Nurses should keep the drain site clean and empty the drains for I&O
measurements as needed.

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Types of Surgical Drains

The surgeon places the type of drain desired in the body part during
surgery.

There are several types of surgical drains.

Jackson-Pratt (JP)
Hemovac
Penrose
Wound vacuum-assisted closure (wound VAC)

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Jackson-Pratt

Bulb manual suction drain

Keep bulb compressed
Wound suction device promotes drainage of fluid from the incisional site
Decreases pressure on tissues
Decreases abscess formation

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Hemovac

Round suction device to promote drainage of fluid from the incisional site
Decreases pressure on tissues
Decreases abscess formation
Portable closed system that applies negative pressure to the wound
Large disc-shaped reservoir for collecting drainage
Keep disc-shaped reservoir compressed

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Penrose

Gravity drain
Promotes healing from inside out
Decreased chance of abscess
Safety pin prevents the exposed end from slipping back into the wound
Apply pre-cut gauze around drain and apply 4x4 with tape over the top of
the drain for wound drainage and to protect the surrounding skin

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Wound VAC

Electronic low-pressure vacuum system

Negative pressure wound therapy is used to provide debridement and

removal of exudate.

This therapy applies suction to a wound area.

It cleanses the would, reduces bacterial counts through debridement,

promotes granulation and epithelialization, and stimulates cell growth.

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Discontinuing Surgical Drains

Surgical drains are usually removed when the drainage has stopped.
Typically 24 to 48 hr after surgery
Aseptic technique should be used when caring for and removing drains.
Always explain the procedure to the client before beginning.

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Steps to Discontinue a Surgical Drain

1. Wash hands.
2. Apply gloves.
3. Expose drain.
4. Remove the dressing.
5. Clamp the tubing if the drain has a vacuum bottle attachment.
6. Note amount of drainage and color.
7. If the drainage looks infected, obtain a swab for culture and sensitivity.
8. Use a stitch cutter if the drain is sutured.
9. Grasp the drain close to the skin using a gloved hand and gently
withdraw the drain onto a gauze. Do not use jerky movements.
10. Check that the entire drain has been removed. The drain should have
a clean cut edge and should not appear to be jagged.
11. Maintain pressure over the drain site with a gauze pad until the
bleeding or drainage is minimal.
12. Dress the site with a dry sterile dressing.

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Removal of Staples

1. Wash hands.
2. Apply gloves.
3. Clean the wound if necessary.
4. Using a staple remover, remove each staple
gently with the remover. Pressure is applied
to the handle of the remover which bends the
staple causing it to straighten the ends of the
staple so that it can be easily removed from
the skin. The staple will back out of the skin.
5. Every other staple should be removed. Once
a staple is removed, Steri-Strips or adhesive
strips are applied and benzoin applied over
the strips.
6. This process is repeated until all staples are
removed.
7. Remove gloves and wash hands.

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Removal of Sutures

1. Wash hands.
2. Apply gloves.
3. Clean wound with an antiseptic to remove any debris.
4. Use sterile forceps to pick up the knot of each suture. Then cut the
suture with surgical scissors.
5. Forceps are used to remove the loosened suture and pull the
thread from the skin.
6. Clean the wound if necessary after the removal of all of the sutures.
7. Adhesive strips may be applied over the wound to allow the wound
to continue strengthening.
8. Remove gloves and wash hands.

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Wound Drainage

Serous
Slightly yellow watery drainage, clear, thin
Serosanguineous
Watery blood tinged drainage, thin, yellow, clear, reddish pink
Sanguineous
Drainage that contains serum and red blood cells, blood serum,
thick
Purulent
Infected drainage with an odor, thick, WBCs, bacteria, debris,
unpleasant odor

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Learning Activity Review Questions

1. A nurse understands that one of the surgical drains debrides the

wound. Which type of drain is responsible for this?

2. A nurse is caring for a client who has a Jackson-Pratt drain in the right
knee after a right total knee arthroplasty. There is a prescription to
discontinue the drain. When discontinuing the drain, the nurse feels
resistance from the drain. What should the nurse do?

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