Drain Insertion

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A surgical drain is a tube that facilitates the removal of blood, pus or other fluids, preventing them from accumulating within a wound.


Indications

Surgical drains are indicated for use in a variety of settings. Some examples are given below.

Chest:

  • Drainage of pneumothorax.
  • Drainage of haemothorax.

Abdomen and Other Cavities:

  • Drainage of a potential space, e.g. post-abscess drainage.
  • Monitoring of outputs, e.g. bile from abdomen.
  • Detection of bleeds or leaks, e.g. anastamotic leaks (remember to be aware of potentially blocked drains).

Procedure

Inserting the Drain

  • A¬†surgical drain will have one end sharp and an one¬†end with perforations to allow for drainage.
  • Insert the drain as deep as possible without catching any nerves or vessels.
    • Counter-traction on the skin often helps when puncturing the skin, but do not ever use your hands as you my accidentally injure yourself.
  • Cut the sharp end, ensure no perforations are outside the skin and cut to length for adequate drainage of the intended cavity.

Securing the Drain

  • To secure the drain, use a non-absorbable suture (commonly silk).
  • Suture around the exit site of the skin, but do not push the first knot onto the skin, instead leave it hanging in the air.
  • Secure the drain by tying knots in front and behind the drain several times.

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