Drain Insertion

Original Author: Ollie Jones
Last Updated: March 18, 2019
Revisions: 20

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

Further Reading

Post-operative abdominal drainage following major upper gastrointestinal surgery: single drain versus two drains
Shrikhande SV et al., J Can Res Ther

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