Thursday, November 12, 2015

Important Notes On 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.

These pipes can prove to be extremely vital in some situations. Once they have been inserted, either free flow or suction can used in draining. Total drainage volume should be determined for the purposes of ensuring healing occurs in the right way and no unwanted bleeding takes place. Care should be undertaken frequently through sterile dressing. The drains may be removed after a day or even seven days based on the kind of wound one is dealing with.

Surgical drains can be open are closed. Closed drains are preferred over the open ones as they minimize the possibility of infection. Open tubes drain on to a stoma bag or gauze. Closed ones drain into a bag or bottle. Examples of closed tubes include orthopedic, abdominal and chest drains. The tubes can also be passive or active. Active ones operate under suction while passive ones are based on negative external pressure.

Taking care of surgical drains requires a systemic approach for efficacy is to be achieved. All drains should be labelled depending on the location and type of fluid being drained. Regular monitoring of the drainage system cannot be over emphasized as overlooking this could lead to serious complications. It is important to note the amount, color and viscosity of the liquid. Any changes that do not conform to the standard expectations should be further looked into and appropriate management carried out promptly.

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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