Drain Insertion - Podcast Version TeachMeSurgery 0:00 / 0:00 1x 0.25x 0.5x 0.75x 1x 1.25x 1.5x 1.75x 2x 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 placed during surgery are indicated for use* in a variety of settings, such as: 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 *Surgical chest drains used in the management of pneumothorax or haemothorax are beyond the scope of this article Procedure The following procedure is to describe the insertion of a surgical drain that is required 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) and come out through the skin Counter-traction on the skin often helps when puncturing the skin, but do not use your hands as you my accidentally injure yourself Cut the sharp end, ensure no perforations on the drain 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 loose Secure the drain by tying knots in front and behind the drain several times Removing the Drain Removal of the drain depends on the indication for which it was inserted and clear instructions of when it can be removed should be in the operation note. Key Points A surgical drain is a tube that facilitates the removal of blood, pus, or other fluids from the operative site Indications for their insertion include the drainage of a potential space, monitoring of outputs, and the detection of bleeds or leaks Once inserted, its output should be monitored closely and only removed when determined appropriate by the surgical team Frequent questions What is the purpose of a surgical drain? A surgical drain is a tube designed to remove blood, pus, or other fluids from a wound or cavity, preventing accumulation. It plays a crucial role in post-operative care by facilitating drainage and monitoring outputs. What are the common indications for inserting a surgical drain? Surgical drains are indicated for the drainage of potential spaces, monitoring fluid outputs, and detecting bleeds or leaks. They are often used after surgeries to manage complications like abscesses or anastomotic leaks. How is a surgical drain inserted during a procedure? To insert a surgical drain, the sharp end is placed deep into the cavity while avoiding nerves and vessels, and it exits through the skin. Proper technique involves counter-traction on the skin and ensuring that no perforations are exposed outside the incision. How is a surgical drain secured after insertion? A surgical drain is secured using a non-absorbable suture, typically silk, placed around the exit site. The first knot should be left loose to avoid pressure on the skin, with additional knots tied in front and behind the drain to ensure stability. When should a surgical drain be removed? The removal of a surgical drain depends on the specific indication for its use and should follow the guidelines outlined in the operation note. It is essential that the surgical team determines the appropriate timing for removal based on the patient's condition. Rate This Article