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surgical drains.ppt
1. Wednesday,
April 12, 2023
1
Drain Insertion
DR. HIWA OMER AHMED
PROFESSOR IN GENERAL AND BARIATRIC SURGERY
UNIVERSITY OF SULAIMANI
COLLEGE OF MEDICINE – SULAIMANI CITY- KURDISTAN
2. Wednesday,
April 12, 2023
2
A surgical drain is a tube that facilitates the
removal of blood, pus, or other fluids,
preventing them from accumulating within a
wound( potential cavity) or cavity.
3. Wednesday,
April 12, 2023
3
Aims of putting
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 presentation
4. Wednesday,
April 12, 2023
4
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
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
5. Wednesday,
April 12, 2023
5
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
6. Wednesday,
April 12, 2023
6
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.
8. Wednesday,
April 12, 2023
8
Open drain
Contained rubber or plastic corrugated sheets
Draind fluid collected in guaze or stoma bag
Increase chance of ascending infection
Not obstructed easily
Example Penrose drain
9. Wednesday,
April 12, 2023
9
Closed drain
A tube draining fluid in to a bag or bottle
Like abdominal and chest drains
Low chance of ascending infection
Keeps the patient clean
We could monitor amount of drainage
Higher incidence of blockage
Example Jackson pratt drain
10. Wednesday,
April 12, 2023
10
Active drains
Maintained under suction
Under low or high pressure
Closed like hemovac drain
Open (sump drain)
11. Wednesday,
April 12, 2023
11
Passive drain
Has no suction
Drains by pressure differentials, overflow and gravity
Closed like NG tube, T tube , Foley’s catheter
Open like Penrose, corrugated
