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Sunday, 14 February 2016

Maintaining A Drain Tube After Surgery

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By Donna Hayes


Many surgical operations that involve the opening up of cavities require that a drainage tube be inserted to help get rid of any fluid that may accumulate within the cavity. Such may include blood, pus or serous fluid. Different types of drains can be used depending on the type of operation that has been performed, the type of wound as well as the preference of the surgeon. We will look at how a drain tube after surgery should be handled.

There are two main methods that are used to remove the fluid: active and passive mechanism. Active mechanisms employ the use of devices that either create a suction force or a vacuum. When using the passive mechanisms, the fluid is allowed to flow freely from a higher region to a lower one under the influence of gravity. The choice of method to employ is determined by a number of factors such as the type of operation and the amount of fluid involved.

When the patient is released to the ward from the operating theater, the nurse on duty should perform the initial inspection. Things to look out for during this initial inspection include the presence of leakages, oozing or redness at the site. They should ensure that the drain has been firmly secured with a suture or a tape. It should be patent without any kinked or knotted areas. All the findings must be properly documented.

Ongoing monitoring should be done in the same manner. Signs of surgical site infection and sepsis should also be assessed. Such signs will include, for instance, redness at the insertion site, oozing and tenderness. If you come notice any of these signs, document and inform the other members that are involved in the treatment of the patient. The next step will be to swab the area and to take a blood sample. The two specimens will be subjected to culture studies.

Ensure that you observe for patency at the beginning and at the end of your shift and that you document appropriately. Ensure also that you observe the same after moving the patient. If a drain becomes blocked, there is a high probability that the fluids will accumulate within the cavity and lead to infections and pain. Consequently, the wound will heal at a much slower rate and the stay of the patient in hospital will be prolonged.

Leakage is fairly common. If you notice a leaking tube, try to reinforce it with more dressing and adhesive tape and observe. If there is dislodgment or blockage, replacement may be needed. Other complications that need intervention include retraction, kinking and adherence to granulation tissue. In most cases of adherent granulation tissue, surgical removal is usually required.

Removal is usually done when the amount of fluid in the collecting jar is less than 25 milliliters per day. Typically, the tube is pulled out and the defect closed with a stitch. Patient should be warned that the process may be a bit painful and should be provided with painkillers if need be. An alternative practice involves gradual withdrawal over a few days. Proponents of this approach argue that it helps the insertion wound to heal faster.

The patient may be discharged from hospital as soon as the drain is removed. Dressing will go on until healing has taken place. Fluid may continue to leak but this should not be a cause for concern unless the volume increases or an infection sets in. The danger signs should be clearly communicated to the patient.




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