Drain Insertion

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


Indications

Surgical drains are indicated for use in a variety of settings, some examples are listed 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. anastomotic leaks

Procedure

The following procedure is to describe the insertion of a surgical drain, such as that typically following a surgical 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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