Your Surgical Drain

You may have a drain placed in the surgical site to remove excess fluid or blood. The drained fluid is collected into a container. You should see the drainage decrease after you go home, and you may see it change color. You will need to care for the drain at home and keep the drain clean. You should be shown how to empty the drain before you are discharged, and you should ask if you need to measure the drainage.

Your surgeon will talk to you about how long to expect the drain to stay in place. The drain site should be emptied at least 2-3 times per day, in order to keep the drain suctioned properly.

Closed Drainage Suction Systems

Closed suction drains use a vacuum to draw drainage out of the wound into a closed system. These drains may be sutured in place to keep them from falling out. See below for drain care.

Wound drainage may contain blood and the tubing can get clots or clogs that may keep the fluid from draining. Your drainage should go from red to pink to watery looking. The amount should continue to decrease each day. Let your surgeon know right away if the amount increases, stays bright red (active bleeding) or becomes green yellow with a bad odor (may mean infection).

Before you empty and measure the fluid, you will need to clear the clots from the tubing each time. This is called stripping or milking the tubing.

Please view this video overview of postoperative surgical drain care, created and produced by Cancer Care Alberta, Alberta Health Services: Breast Cancer Surgery – Drain Care (alberta.ca)

The below are common instructions for drain care.  Review with your surgical care team.  They may have different instructions for you.

Gather supplies:

• measuring cup
• alcohol swab or lotion (optional)
• gloves (optional)
• 60% alcohol based hand gel (hand sanitizer)
• Drain Measurement Log and pen

Wash your hands with soap and water or hand gel.

Clear the drainage tube

• Firmly hold the tubing near where it comes out of the skin. Keep this hand holding firmly.
• Grasp the tubing with your other hand.
• Squeeze the tubing so it becomes flat
• Slide your fingers down the tubing toward the drain bulb. (You may use an alcohol pad or apply lotion around the tubing to make it easier to slide your fingers down the tubing.)
• Release the tubing.

Empty the drain bulb

• Hold the bulb so the opening points away from you.
• Open the cap on the bulb
• Squeeze the drainage into a measuring cup.
• Hold the bulb opening away from you.
• Squeeze the bulb to make sure there is suction from the wound site.
• Cap the squeezed bulb.
• Secure the drain to your clothing, using tape or a safety pin.
• Use the Drain Measurement Log to write down the amount of drainage.
• Pour the drainage into a toilet and flush.
• Wash your hands.

Call your doctor if the drain fluid is cloudy, bad smelling, or the amount of drainage has increased.

The below are common instructions for drain care.  Review with your surgical care team.  They may have different instructions for you.

Gather supplies:

• gauze (including 4x4 split gauze)
• paper tape
• clean gloves (optional)
• soap and warm water
• 60% alcohol based hand gel (hand sanitizer)

Wash your hands with soap and water or hand sanitizer.

Remove the old dressing

• Check the dressing for unusual or bad-smelling drainage.
• Wash your hands.
• Check the skin around the tubing for any redness, swelling, warmth, or bad-smelling drainage.

Clean the skin

• Use soap and water.
• Pat dry.

Apply the new dressing

• Open the split gauze dressing. Hold the gauze at the corners or edges. Try to not touch the part of gauze that will be laying on the incision site.
• If you were not given split gauze, clean scissors with soap and water (or an alcohol swab) and make a slit halfway through a gauze pad.
• Apply antibiotic ointment around the skin opening if instructed to do so by your surgical team.
• Place the split gauze opening around the drain.
• Place a second gauze on top of the split gauze to protect the drain and cover the insertion site.
• Tape around the gauze to secure it into place.
• Wash your hands.

Keeping You Informed

You may have a clear dressing over the drainage insertion site. You may need to leave it on for several days.