How To Take Care of Your Drains After Breast Surgery (2022)

If you are having a mastectomy for breast cancer treatment of prophylaxis, you will most likely have surgical drains in place when you go home. Surgical drains are also usually placed during breast reconstruction surgery. Your surgeon or nurse will give you instructions on how to manage your drains, but knowing what to expect can make living with drains a bit easier.

The Purpose of Drains

Surgical drains perform an important role in healing after breast surgery. Fluid often builds up in the area where a breast is removed and can cause discomfort and delay healing if it is not drained.

Drains also reduce the chance that you will develop a seroma, a collection of fluid that can be uncomfortable and sometimes cause scarring. For this reason, your surgeon will place drains in the regions where fluid is expected to accumulate.

The downside of drains is that they offer bacteria a way to enter the body, so keeping the area around your drains clean and dry is important.

While there are different types of surgical drains, the type used most often for breast surgeries is the Jackson-Pratt drainage system. These drains are placed within your surgical field and are attached to flexible tubing that passes through and is stitched to your skin. The tubing is capped with a soft plastic bulb, which catches and holds the fluid, and a stopper outside of your body.

How To Take Care of Your Drains After Breast Surgery (1)

Most drains are left in place for two to three weeks, but some may be removed before you leave the hospital and others may need to be left in place for longer than three weeks. The risk of infection, however, begins to increase rapidly after they have been in place for 21 days.

Surgeries ThatTypically Require Surgical Drains

Surgeries requiring drains are those in which fluid collects during healing. Drains are usually required following amastectomy or reconstructive breast surgery. You may have only one drain, or you may have five or more if you have a bilateral mastectomy with immediate reconstruction.

A separate drainage tube is often placed if you have a lymph node dissection. You will not usually need a drainage tube if you are undergoing asurgical biopsy,lumpectomy, or a sentinel node biopsy.

(Video) Breast Surgery Drain Care Instructions

The location of your drains will depend on the surgery you have, but often includes a drain at your mastectomy site and one in your armpit if you have lymph nodes removed.

How to Care for Surgical Drains

When you wake up from surgery, your recovery room nurse will probably warn you that you need to be careful with your drains. Depending on the length of the tubes (usually 14 to 18 inches), it's easy to get these tangled up with IV lines, your bedclothes, and anything else nearby.

Your nurse will periodically drain your bulbs and show you how it's done. He or she will log the amount of drainage from each tube, and you will be instructed to continue the log on your own until your drains are removed.

Before you leave the hospital, your healthcare team will review drain management, tell you about symptoms that should prompt you to call, and schedule a follow-up visit to have them removed.

Emptying and Tracking Drainage

Always wash your hands before and after each measurement. Early on, you'll likely have around 100 cc drainage per day, but this will steadily decrease. You may be asked to empty your drains two to four times daily, or whenever they become about half full.

Note the color and consistency of the drainage. Early on, it will be bright red, but this should change to a straw color after a few days. After emptying your bulb into the toilet, rinse it with water and gently compress it to make sure a vacuum is recreated when you close the system. It is very helpful to have someone assist you with draining your surgical bulbs, if possible.

If you notice an increase in the amount of fluid, think about what you have been doing that may be causing that.

Increased drainage may be a sign that you've been too active and need to take it easy for a few more days.

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Keep the insertion site clean and dry by washing with soap and water and gently patting dry.

Signs and Symptoms of Infection

Having drains provides bacteria an access route to your body, and the longer drains are in place, the greater the risk of infection.

Signs of a drain-related infection may include:

  • A fever with a temperature of 101 degrees F (38.3 C) or higher
  • Redness of your skin surrounding the drain
  • Hardness or firmness where the drain exits your body
  • Thickening rather than thinning of the drained liquid
  • Foul smelling drainage or pus at the entry site
  • Pain or discomfort at your drain sites
  • A sudden change in the smell or color of the drainage

How to Prevent Surgical Infections

Keeping Drains in Place

One of the most difficult parts of having surgical drains is managing both the tubes and the drainage collection ports.

Having a special drain management garment can be a lifesaver. There are special cotton camisoles designed just for this purpose. A good one has pockets or pouches where you can insert the bulbs to keep them secure, is sturdy enough to attach and reattach safety pins to control the lines, and minimizes seams that could rub against your incision sites and be uncomfortable.

This keeps the drains secure so they don't pull on your wound site or swing freely and possibly catch on things. Some camisoles even have pockets in which you can insert soft cotton breast forms.

Other options include large, roomy blouses, and oversized sweaters or sweatshirts that open in the front.

For some time after surgery, it may be difficult to pull clothing over your head, so keep this in mind when you shop. When you go to sleep at night, pay attention to the location of your drains. If you are an active sleeper, you may need to sleep on your back or in a recliner to prevent dislodging them.

Style and Comfort After Breast Surgery

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Daily Life With Drains

It's far too easy to catch your drain tubes on something if they are not secure. Stretching and pulling is also difficult for some time after surgery, especially with drains in place. Before your surgery, it's helpful to place commonly used items in a place where you won't have to stretch or bend to reach them. (This is also a good task to give to someone who is looking to help during this time.)

After surgery, additional adjustments to your daily life will be needed.

Driving

Surgeons differ as to recommendations about driving with drains, and some recommend avoiding this altogether. (You should also avoid driving if you are taking pain medications.) When you ride in a car, you may wish to position a small, soft, but relatively flat pillow between your surgical site and drains and your seat belt.

Bathing

Your surgeon will let you know how long you need to wait to bathe after surgery. Healthcare Providers also differ with regard to bathing instructions. Some recommend you only do sponge baths until your drains are removed, though you may be able to use a detachable shower head to wash from your waist down.

Washing your hair can be a bit of a challenge due to limited motion in your arms, and it can be uncomfortable to lean over the sink. Some people find that treating themselves to a shampoo at a hair salon is a good option.

Soaking in a tub or entering a hot tub is not recommended while you have drains in place.

Common Drain Problems

Problems that can occur with drains include:

  • Increased drainage: Some people note increased drainage if they are too active, while others don't find this to be the case.
  • Clots in the tubing: On occasion, patients will find a clot in their tubing. If this occurs, try gently kneading the area.
  • Loss of vacuum pressure: If a proper vacuum isn't created after emptying your bulb, your drain may fail to remove fluid. If this occurs, the build-up in fluid can be uncomfortable.
  • Infection: Drain site infections are not uncommon and are more likely the longer your drains are in place.

When to Call Your Healthcare Provider

You should call your surgeon if you have any concerns or questions at all, or if you develop any of the following problems:

(Video) How to Properly Care for your Surgical Drain - Moffitt Cancer Center

  • If your drainage is bright red for more than two or three days
  • If you develop any signs or symptoms of an infection as noted above
  • If a large amount of fluid is leaking from where the drain tubing is inserted into the surgical site
  • If your drainage output suddenly decreases or stops abruptly
  • If your drainage becomes thicker rather than thinner as time goes on
  • If your bulb loses suction
  • If your drain falls out

Having Your Drains Removed

Surgeons vary on the length of time they want drains left in place. Most recommend drains be removed when there is less than 25 to 30 cc total coming from a drain in 24 hours. If you are still having more than 30 ccs draining after a drain has been in place for three weeks, the risk of infection appears to outweigh the benefit of leaving drains in place any longer.

Your surgeon will remove your drains by cutting the suture holding it in place and gently pulling out the tubing. You may notice a pulling sensation, but this only lasts a few minutes. Most people do not need any pain medications for this procedure.

Once your drain is out, ask your surgeon what kind of undergarments he or she recommends. Your bras should be supportive, comfortable, and not too tight. Underwire bras should be avoided.

You will have small scars where the tubing exited your skin, but these often fade over time.

A Word From Verywell

Post-surgical drains can be a nuisance, but they are an important aspect of healing. As the amount of your drainage decreases each day, think of it as signifying being one step closer to being cancer-free.

Frequently Asked Questions

FAQs

How long does drainage last after breast surgery? ›

How Long Should a Drain Be Left in after Breast Surgery? Drains are left in until the fluid output reaches a low level. This is usually less than 20-30 cc (cubic centimeters) per day for two consecutive days – about 2 tablespoons. Most drains are removed one to three weeks after surgery.

How do you shower with breast drains? ›

You may shower with your drain. It's important to hold the tubing of the drain in place while you're in the shower so it's not pulling against your skin. You can do this by wearing a cloth belt around your waist and securing the drain to the belt with a safety pin while you're in the shower.

What is the stringy stuff in my surgical drain? ›

You may see some air bubbles or pieces that are stringy, white, or bloody in your tubing or drainage container. This is normal. It's important to make sure the tube doesn't get clogged. “Milking” the tube may help to move small pieces of tissue or clots out of the tube.

Does removing breast drains hurt? ›

Having Your Drain Removed

Having a drain removed can be best described as a pulling or stinging sensation, which only last a few minutes. You don't need pain medication for this procedure. Once your drain is out, you can wear your own bras. Just remember, don't wear any underwire bras.

How long do drain holes take to heal? ›

My patients usually reach that minimum drainage amount around 7 days post op, give or take a few days. I find leaving drains in over 2 weeks can lead to excess scar tissue encasing the drain itself, making it difficult to easily remove; it can also pose an increased risk of infection at the entry site.

How do you shower with a surgical drain? ›

You may shower after you remove the bandage, but don't take a tub bath or submerge the area in water (such as in a bathtub or swimming pool) until your incision is completely closed and there's no drainage. Wash the site gently with soap and rinse the area with warm water. Pat the area dry.

How much drainage is normal after breast augmentation? ›

This is normal. As your surgical site heals over the next several days, the drainage will change colors. It can progress to a light pink, light yellow, or clear consistency. The drain will stay in place until less than 25 to 30 milliliters (ml) of fluid can be collected in a 24-hour period.

Can surgical drains get clogged? ›

A surgical drain can become clogged at the openings or along the length of the tube, and thus, prevent drainage of fluids.

How often should surgical drains be emptied? ›

Empty the reservoir at least two times a day, even if it's not full. You may need to empty it more than twice if it gets full. Change the dressing around the wound at least once a day, or more often if it becomes soaked or dirty.

What does dark blood in drains mean? ›

If sanguineous drainage continues to flow, it may actually be a sign of hemorrhage. Hemorrhage occurs if there's been damage to an artery or vein. If the blood is bright red and spurting, it may mean that an artery wall has ruptured. If the blood is dark red and steadily flowing, it may mean a vein has ruptured.

How long do I have to sleep elevated after breast reduction? ›

After sleeping in an elevated position on your back for at least four to six weeks, you can usually transition to just sleeping on your back, flat on your bed, for a few weeks.

How much weight do you lose after breast reduction? ›

It largely depends on the size of your breasts and the frame. On average, a total of two to eight pounds is removed from the breasts during a breast reduction surgery.

When can I lift my arms after breast reduction? ›

Lifting your arms over your head, bending and heavy lifting should be avoided for the first few days after breast reduction surgery. After several days have passed, you may gradually increase your daily activities. Anything strenuous should be avoided for a minimum of six weeks to promote complete healing.

What happens to fluid after drains are removed? ›

Answer: Fluid after drain removal

Your body will naturally absorb the drainage as long as it is not excessive and decreasing in production. If the fluid continues to accumulate, then you can develop a seroma (fluid collection).

How long do drainage tubes stay in? ›

Your surgeon will usually remove the bulb when drainage is below 25 ml per day for two days in a row. On average, JP drains can continue to drain for 1 to 5 weeks.

Why do we squeeze the bulb of the drain after emptying? ›

Squeezing or "milking" the tube of your surgical drain can help prevent clogs so that it drains correctly. Your doctor will tell you if and when you need to do this. In general, you do this when: You see a clot in the tube that prevents fluid from draining.

Can I remove my own surgical drain? ›

To remove the drain, remove any visible tape that may be securing the tubing to your skin or dressing. Gently pull the plastic tubing out. There may be slight discomfort but the tube should pull out easily. You should leave the rest of the bandage intact unless the physician has instructed you otherwise.

How much drainage is too much after mastectomy? ›

Most recommend drains be removed when there is less than 25 to 30 cc total coming from a drain in 24 hours. 7 If you are still having more than 30 ccs draining after a drain has been in place for three weeks, the risk of infection appears to outweigh the benefit of leaving drains in place any longer.

Why do they put drains in after breast surgery? ›

Surgical drains are intended to prevent excessive accumulation of fluid after breast reconstruction. This reduces swelling and prevents seromas and other post-op complications.

How do you take care of a JP drain at home? ›

Home care
  1. Don't sleep on the same side as the tube.
  2. Secure the tube and bag inside your clothing with a safety pin. ...
  3. Empty your drain at least twice a day. ...
  4. Change the dressing around the tube every day. ...
  5. Keep the bandage and tube site dry when you shower. ...
  6. “Stripping” the tube helps keep blood clots from blocking the tube.

How long can surgical drains stay in? ›

Your surgeon will usually remove the bulb when drainage is below 25 ml per day for two days in a row. On average, JP drains can continue to drain for 1 to 5 weeks.

Can surgical drains get clogged? ›

A surgical drain can become clogged at the openings or along the length of the tube, and thus, prevent drainage of fluids.

How do you clean a surgical drain? ›

Your doctor will tell you how often to change it.
  1. Wash your hands with soap and water.
  2. Take off the dressing from around the drain.
  3. Clean the drain site and the skin around it with soap and water. Use gauze or a cotton swab.
  4. When the site is dry, put on a new dressing. ...
  5. Wash your hands again with soap and water.

How do you sleep with a JP drain? ›

Sleep on the side opposite of the drain. This will help you to avoid blocking the tubing or pulling it out of the suction bulb. Ask your doctor about when it is safe to shower, bathe, or soak in water.

How do you take care of a drain tube? ›

Your doctor will tell you how often to change it.
  1. Wash your hands with soap and water.
  2. Take off the dressing from around the drain.
  3. Clean the drain site and the skin around it with soap and water. Use gauze or a cotton swab.
  4. When the site is dry, put on a new dressing. ...
  5. Wash your hands again with soap and water.

How often should you change JP drain dressing? ›

Dressing Your Drain Site

Starting the day after surgery, change your dressing daily or when it becomes soiled with drainage. (some drains may be left open to air if instructed by provider) 1) Wash your hands with soap and water.

What happens if drains are left in too long? ›

The reason for leaving the drain tubes in is to decrease ti chance of fluid collection (seroma). However, leaving the tubes in too long can increase the chance of infection at the tune sites and potentially into deeper space.

Can surgical drains be left in too long? ›

A closed suction drain in the surgical field can decrease seroma formation and possibly reduces the risk of infection. However, prolonged drain duration may increase infection rate due to ascending infection.

What happens to fluid after drains are removed? ›

Answer: Fluid after drain removal

Your body will naturally absorb the drainage as long as it is not excessive and decreasing in production. If the fluid continues to accumulate, then you can develop a seroma (fluid collection).

How can you tell if your drains are infected? ›

Look at the drainage to see if it has an unusual color or odor. Look at the drain insertion site to see if there is any tenderness, redness, warmth to touch or pus. These are signs of infection.

How often should surgical drains be emptied? ›

Empty the reservoir at least two times a day, even if it's not full. You may need to empty it more than twice if it gets full. Change the dressing around the wound at least once a day, or more often if it becomes soaked or dirty.

Can I remove my own surgical drain? ›

To remove the drain, remove any visible tape that may be securing the tubing to your skin or dressing. Gently pull the plastic tubing out. There may be slight discomfort but the tube should pull out easily. You should leave the rest of the bandage intact unless the physician has instructed you otherwise.

How much drainage is too much after surgery? ›

In general, a drain is removed when there is less than 30 cubic centimeters (1 ounce) of fluid for two straight days or three weeks after surgery, whichever comes first.

How much drainage is normal after breast augmentation? ›

This is normal. As your surgical site heals over the next several days, the drainage will change colors. It can progress to a light pink, light yellow, or clear consistency. The drain will stay in place until less than 25 to 30 milliliters (ml) of fluid can be collected in a 24-hour period.

Is it normal to bleed after drain removal? ›

It is normal to have a little bit of drainage after the drain has removed. The skin wound will need a few days to fully close and until that happens some fluid can leak. However, there should not be a large amount of drainage, nor bright red blood. If this happens, go see your surgeon immediately.

Videos

1. Breast Reconstruction | Surgical Drain Care
(Johns Hopkins Medicine)
2. How to Properly Care for your Surgical Drain - Moffitt Cancer Center
(Moffitt Cancer Center)
3. Going Home After Breast Cancer Surgery with Drains
(Princess Margaret Cancer Centre)
4. How to Care For Your Drains After Plastic Surgery
(Dr Anzarut Plastic Surgery)
5. Caring for your drain at home: After Breast Cancer or Melanoma surgery
(Sunnybrook Hospital)
6. How to care for a post-surgery wound drainage system and gauze dressing
(MD Anderson Cancer Center)

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