Patient education: How to care for a negative pressure drain (The Basics)

What is a negative pressure drain? — A drain is a tube used to remove fluid from a space inside the body or around the cut made during surgery. The doctor puts it in at the end of surgery.

A "negative pressure drain" has a collapsible container attached. One end of the tube stays under the skin, and the end with the container stays outside of the body. The drain pulls extra fluid out of the body by creating suction in the tube and collecting it in the container. You need to empty the container regularly.

Drains with a suction bulb are sometimes called a "Jackson-Pratt" or "JP" drain (figure 1). Drains with a flat, round container are sometimes called a "Hemovac" (figure 2).

It is normal for fluid to build up around where the skin was cut during surgery. Using a drain to remove the extra fluid helps you heal faster.

How do I care for myself at home? — Ask the doctor or nurse what you should do when you go home. Make sure that you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.

Before you go home, your doctor or nurse will talk to you about how much drainage to expect. The fluid might look bloody at first, then change to a light pink or yellow color over time. This is normal.

Make sure that you know:

●How to care for the drain

●How often to empty the drain

●How to measure the fluid

●What to do if the drain comes out, does not put out fluid, or puts out too much fluid

How do I empty the drain? — To empty the drain:

●Wash your hands before and after touching the drain or the skin around the wound.

●Remove the stopper on the container. Pour out the fluid. If your doctor or nurse asked you to measure the amount of fluid, pour it into a measuring container and write down the amount along with the date and time. You can also note the color of the fluid and whether it has a smell.

●Squeeze the container with the stopper open to get the air out. Put the stopper back in while keeping the container squeezed. With the stopper closed, the container should look collapsed or compressed. This means that it is working to pull fluid out of your body.

●If the tube is blocked, your doctor or nurse might tell you to "milk" or "strip" the tube to clear it out. Be careful not to pull the drain out. Use 1 hand to pinch the tube near where it comes out of your body. While keeping that hand in place, use your other hand to pinch and move your fingers all of the way to the container before letting go. This will push any blockages out of the tube and into the container, while also making sure that you don't pull on the drain.

●After you measure the drained fluid and record the amount, flush it down the toilet.

Why do I need to track my drainage? — When you go home with a drain in place, your doctor might want you to keep track of how much fluid comes out of it. This will help the doctor know when the drain can be removed.

How do I keep track of my drainage? — When you empty your drain, pour the fluid into a measuring cup or container. Write down the amount along with the date and time.

Your doctor will tell you how to share this information with them. They will also tell you if you should keep track of anything else, like the color of the fluid or whether it has a smell. Some doctors might have you put the information into an online "portal." Or they might ask you to share it by email or phone.

Some people prefer to use a paper chart to keep track of the drainage (table 1). You can print out this chart and write down the amount of drainage each time you empty the drain. Bring the chart with you when you see your doctor.

What else should I know?

●Keep the skin where the tube comes out clean. Your doctor or nurse will show you how to change the bandage if needed.

●Avoid bumping the drain. Sleep on the opposite side. Depending on where the drain is, you might need to wear a special wrap or piece of clothing that helps hold it in place.

●Avoid separating the tube from the drainage collection container.

●Keep the container compressed at all times, except when emptying.

●Follow all instructions about activity after surgery.

●Follow all instructions about bathing or showering.

Your doctor or nurse will tell you when the drain can come out. This is usually done when the fluid collected by the drain gets below a certain amount and is of a healthy color and thickness. Drains are usually removed in the doctor's office or clinic.

When should I call the doctor? — Call for advice if:

●You have any signs of infection, including:

•Fever of 100.4°F (38°C) or higher, or chills

•Pain, swelling, warmth, or redness of the skin where the tube comes out

●A part of the tube that used to be under the skin comes out of your body.

●The container does not stay collapsed or compressed.

●The tube gets a crack in it or separates from the container for a long time.

●The tube is blocked, and you cannot clear it.

●There is a lot of fluid leaking from around the drain.

●The amount of fluid in the drain increases a lot or stops suddenly.

●The fluid in the drain changes in color (for example, looks green or brown), thickness, or smell.

●You have any new or worrying symptoms.