Sunday, November 15, 2015

Essential Principles Regarding Surgical Drain Management

By Mattie Knight


Retention of fluids such as pus or blood in wounds can result infection and even more serious complications. Surgical drain management therefore comes in handy if timely prevention of complications is to be achieved. The drain is simply a tube inserted within the wound to keep it fluid free. One should keep in mind that these drains are not used as a means for faster wound healing.

Surgical drains are being replaced by better technological methods due to the challenges and risks involved when using these tubes. One the challenges is that the tube blockage can occur anywhere along the tubing thus limiting drainage. In such cases, the drain should be immediately removed and replaced with another since failure to do this may result in sepsis. Another common problem facing their use is that it makes the patient uncomfortable and limits their movement.

Despite this drains being slowly faced out there are circumstances where there are no alternatives. Inserted tubes can last from twenty four hours to a week depending on the type of surgical wound. Routine dressing needs to be done to prevent acquisition of infection. Also, amount of fluid should always be measured to detect any excess bleeding and to ensure good healing process. Drainage is usually done achieved naturally flow or through a suction wall.

Surgical drains can be active or passive. Passive tubes are those which drain naturally, that is, they depend on lower external pressure compared to pressure within the wound. Active tubes rely on suctioning independent of pressure. The conduits can also be termed as open or closed. The external end of open tubing drains into a gauze pad or a bag. Closed tubes are connected to specific containers that hold the fluid in the process of drainage. Closed drains have an advantage of the open ones since they reduce the risk of infection.

Managing surgical tubes is very important if proper healing is to be achieved. The first step is labeling the drain as per the site and category of fluid to be drained. Some knowledge is however required when it comes to monitoring for changes taking place in the set up. The expected color and consistency depends on what fluid being drained. Any changes outside the standard expectations should be addressed. Interrupted drainage could indicate leakage or clogging and need to be addressed as well.

The expected appearance and viscosity in majority of cases differs at the start and towards the end of the procedure. In the initial post surgical period, the fluid tends to be in large quantities, dark reddish and thick attributed to accumulated blood after the operation. With time, the liquid turns brighter, thinner and smaller in volume as recovery progresses. Extremely bloody appearance at the beginning may be an indication of bleeding from within.

To remove the tubing, make sure all the requirements are ready beforehand. The main ones include gloves, disposable drapes, a suture removal kit and dressings. Drainage within the last twenty four hours should be recorded to serve as a comparison if further flow occurs. Prepare the patient beforehand regarding the expected discomfort they may experience, analgesics may be required to minimize pain.

With the disposable drape adjacent to the wound site, begin by removing stitches followed by carefully pulling out the suture from the end where the knot is. Slightly loosen the drain to dislodge any tissue that may grown around it then pull it out with caution. If any resistance is met, consider surgical removal. Cover the site the wound site with dressing and document the procedure.




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