A nurse is planning care for a client who is postoperative and has a closed-wound drainage
Chapter 4. Wound Care Show Drain ManagementDrains systems are a common feature of post-operative surgical management and are used to remove drainage from a wound bed to prevent infection and the delay of wound healing. A drain may be superficial to the skin or deep in an organ, duct, or a cavity such as a hematoma. The number of drains depends on the extent and type of surgery. A closed system uses a vacuum system to withdraw fluids and collects the drainage into a reservoir. Closed systems must be emptied and measured at least once every shift and cleaned using sterile technique according to agency protocol. Drainage tubes consist of silastic tubes with perforations to allow fluid to drain from the surgical wound site, or separate puncture holes close to the surgical area. The drainage is collected in a closed sterile collection system/reservoir (Hemovac or Jackson-Pratt) or an open system that deposits the drainage on a sterile dressing. Drainage may vary depending on location and type of surgery. A Hemovac drain (see Figure 4.3) can hold up to 500 ml of drainage. A Jackson-Pratt (JP) drain (see Figure 4.4) is usually used for smaller amounts of drainage (25 to 50 ml). Drains are usually sutured to the skin to prevent accidental removal. The drainage site is covered with a sterile dressing and should be checked periodically to ensure the drain is functioning effectively and that no leaking is occurring. Checklist 39 outlines the steps to take when emptying a closed wound drainage system. Checklist 39: Emptying a Closed Wound Drainage System
Drain RemovalRemoval of a drain must be ordered by the physician or NP. A drain is usually in place for 24 to 48 hours, and removal depends on the amount of drainage over the last 24 hours. Checklist 40 outlines the steps for removing a wound drainage system. Checklist 40: Drain Removal
Video 4.6Watch the video JP Drain Removal by Renée Anderson & Wendy McKenzie, Thompson Rivers University.
|