Surgical drains are tubes placed after surgery to remove fluids from a wound. They do not improve healing or prevent infection on their own but can help drain fluid that could cause issues. There are different types including open or closed drains, active drains with suction or passive drains, and examples are described like Jackson-Pratt drains and Penrose drains. Risks of drains include infection, breakage, or pain upon removal, so care must be taken with maintenance and removal.

1. Fadi Nather Hawa
Ruba Smadi

2. • A surgical drain is a tube usually placed after
surgery to remove pus, blood or other fluids
from a wound .
• Drains inserted after surgery do not result in
faster wound healing or prevent infection but are
sometimes necessary to drain fluid which may
accumulate at the site of the surgery and in itself
become a focus of infection.

3. 1. To prevent the accumulation of fluid (blood,
pus and infected fluids).
2. To prevent accumulation of air resulting in to a
dead space.
3. To form a controlled fistula e.g: after common
bile duct exploration indication.
4. Surgical drains commonly are used after
procedures on the thyroid , breast and axillary
area , abdominal procedures and joint
replacements.

4. 1. Open or closed:
• Open drains: (Including
corrugated rubber or plastic
sheets) drain fluid on to a
gauze pad or into a stoma bag.
These drains are likely to increase
the risk of infection.
• Closed drains: are formed by tubes draining
into a bag or bottle. e.g. include chest,
abdominal and orthopedic drains. Generally,
the risk of infection is reduced.

5. 2. Active or passive:
• Active drains: are maintained under suction
(which may be low or high pressure)
e.g: Redi-vac drain (high negative pressure),
jackson pratt and four channel vacuum drains
(low negative pressure)
• Passive drains have no suction and work
according to the differential pressure between
body cavities and the exterior e.g: Penrose drain.

6. Advantages Disadvantages
Keep wound dry - efficient fluid
removal
High negative pressure may injure
tissue
Can be placed anywhere Drain clogged by tissue
Prevent bacterial ascension
Help appose skin to wound bed –
quicker wound healing
Allows evaluation of volume and
nature of fluid

7. Advantages Disadvantages
Allow evaluation of volume and nature
of fluid
Gravity dependent – affects location of
drain
Prevent bacterial ascension Drain easily clogged
Eliminate dead space
Help appose skin to wound bed –
quicker healing
Passive

8. • First method : used with drains that have a
sharp trocar attached to the tube.
1. The surgeon uses the trocar with some drains
attached to pierce the skin from the inside of
the wound at the desired site and pulls the
attached tube out through the stab wound.
2. The surgeon places the inner end of the tube at
the required site and detaches the trocar.
3. connect the tube to the reservoir.

9. • Second Method: used when a trocar is not attached
to the drainage tube.
1. The surgeon used a forceps to pierce the
abdominal wall from the inside of the wound and
pushes the forceps through the subcutaneous
tissue.
2. He or she then incises the overlying skin with a
scalpel
3. The surgeon opens the tip of the forceps to grasp
the end of the drain tube and pulls the drain into
the wound to the desired location.
4. connects the tube to the reservoir after the wound
is closed.

10. 1. Jackson-Pratt drain:
consists of a tube
connected to a see-
through collection bulb.
The bulb has a drainage
port which can be
opened to remove fluid
or air so that the bulb
can be squeezed to
create suction. The
drain is placed below
the area of the wound.

11. 2. Four channel vacuum
drains: A four-channel
vacuum drain is a type
of low pressure drain,
The drain tube is soft
and flexible, and the
reservoir is foldable
with two outlets. One
outlet is used for
connecting to two
drains and another
outlet is used for
emptying the contents.

12. 3. Redi-vac drain: this
drain consist of a clear,
plastic reservoir with a
rubber cap that has
indicator wings to
monitor the presence of
vacuum pressure and an
opening in which to
connect the drainage
tube.

13. 4. Penrose drain: is a
passive drain . It
consists of a soft rubber
tube placed in a wound
area, to prevent the
build up of fluid.

14. 5. Pigtail drain: is a
sterile, thin, long,
universal catheter with
a locking tip that forms
a pigtail shape, hence
its name. A guide wire
is also part of the sterile
insertion kit.

15. 6. T – tube: a tube
consisting of a stem
and a cross head , it is
used as a temporary
post operative drainage
of common bile duct .
Sometimes it is used in
ureteric problems too.

16. • Breakage
• Difficulty in removal
• Inadvertent removal
• Infection
• Occlusion
• Pain
• Unsightly scar
• Visceral perforation

17. 1. The negative pressure in the reservoir should
be released
2. The bulb or reservoir should be disconnected
before the drain is removed
3. the nurse or patient smoothly pulls out the
drain
• Drain removal can be painful for some patients,
so the patient may wish to take an oral analgesic
before removing the drain.