Dr. Hiwa Omer Ahmed gives a presentation on inserting surgical drains. The document discusses the aims of inserting drains such as drainage or monitoring outputs. It describes how to insert a drain by placing it deep in the cavity and securing it with sutures. The document outlines types of drains including open versus closed and active versus passive drains. Finally, it briefly mentions complications and post-removal care.

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April 12, 2023
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Drain Insertion
DR. HIWA OMER AHMED
PROFESSOR IN GENERAL AND BARIATRIC SURGERY
UNIVERSITY OF SULAIMANI
COLLEGE OF MEDICINE – SULAIMANI CITY- KURDISTAN

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April 12, 2023
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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( potential cavity) or cavity.

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April 12, 2023
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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

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April 12, 2023
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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

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April 12, 2023
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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

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April 12, 2023
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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.

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April 12, 2023
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Types of drain
 Open versus closed
 Active versus passive

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April 12, 2023
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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

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April 12, 2023
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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

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April 12, 2023
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Active drains
Maintained under suction
 Under low or high pressure
 Closed like hemovac drain
 Open (sump drain)

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April 12, 2023
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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

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April 12, 2023
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Complications

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April 12, 2023
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April 12, 2023
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Post-removal care