Wednesday, June 1, 2016

Taking Care Of A Drain Tube After Surgery

By Brenda Perry


Drain tubes are usually needed after operations that involve the opening up of body cavities. The role of these tubes is to facilitate the removal of fluids from the sites for a few days. Depending on the type of operation, such fluids may include pus, serous secretions, blood or even mucous. There are a number of things that you need to know so as to effectively manage a drain tube after surgery.

There are two main mechanisms that are involved in removing the fluid: active and passive. The passive process is dependent on gravity. It involves the connection of a jar to the drain and its placement below the level of the patient. This differs from the active process in which a negative suction force has to be applied in the form of a suction machine or vacuum. The choice depends on the type of operation conducted, expected consistency of fluid and surgeon preference.

The tube is usually left in position as the patient comes from the operating room to the post-operative ward. The most important thing from this point onward is to conduct regular inspections to ensure that the drain is functioning properly. Signs of malfunction include, among others, leakage of the fluids, redness and oozing.

The inspections should ideally be done at four hour intervals. The routine is the same every time: ensure that the tube is not kinked or knotted, check for signs of leakage and oozing and to check that there is no blockage. Infections are a common complication and they may be localized or generalized. Elevated fevers, increased tenderness and redness around the insertion site are highly suggestive of infection.

Leakage is likely to be seen if the tube if the incision around the tube is not properly closed to form an air-tight seal. The same may occur if a patient is moved from one place to another. The stop-gap measure in such a situation is to reinforce the incision site with dressing and adhesive tape. If the leakage is too much, secondary closure using sutures may have to be done.

It is important that all the findings after each inspection are properly documented. This is especially important for the monitoring of the amount of fluid that is being drained; there is a need to know whether it is increasing or reducing. In the event that any abnormalities are noticed the head of the treatment team is informed so that the problem can be rectified.

The tube is usually removed once it stops draining or when the amount that is drained per day reduces to less than 25 milliliters. The removal process may be painful so it is advisable that patients receive some painkillers before it is done. Persons that have had the drain for a prolonged period of time are likely to experience more pain due to the formation of granulation tissue around it. The defect that is left is closed with a few stitches.

Unless there is another problem that requires observation, patients can be released from hospital on the same day that the tube is removed. Antibiotics are usually given for several days as prophylaxis against infections and dressing is also continued. Patients should be warned to come back immediately for evaluation if there is excessive oozing from the site, if they develop a fever or if the area becomes tender and reddened.




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