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Drain and Suture Line Care for Wounds
Your physician has discharged you with a drain (a system of tubing and a
collection device) to remove fluid or air from your wound. This drain system
will require care at home. The following instructions will help you and your
caregiver correctly perform drain and suture (incision) line care for wounds.
Required supplies for drain and suture line care
You will need the following supplies to perform drain and suture line
care:
- A clean basin, bowl or cup
- A measuring cup
- Hydrogen peroxide
- Regular saline solution or distilled water
- Cotton-tipped applicator or swabs
- Antibiotic ointment (bacitracin, neomycin or triple antibiotic ointment)
- A record sheet to record the amount of drainage (see example on back)
These supplies can be purchased at a drug or grocery store.
Drain instructions
Drain care is a clean procedure. Supplies do not need to be sterile,
but you must wash your hands thoroughly with soap and warm water before
performing drain care.
- Perform drainage care twice a day.
--Discard the drainage once in the morning and once in the evening.
--Try to empty the drain at the same time each day.
- Pull the stopper out of the drainage bottle and empty the drainage fluid
into the measuring cup.
- Record the amount of drainage fluid on the record sheet.
- Dispose of the drainage fluid in a toilet or rinse it down a sink.
- Reestablish drain suction. (See "Types of Drains" for
instructions on re-establishing suction.)
Various types of suction devices are used on wound drain systems. Prior to
your discharge from the hospital, a nurse will specify which type of drain and
suction device you have and will instruct you on proper drain care for your
wound.
Types of drains
Jackson-Pratt
This oval-shaped suction system is about the size and shape of a large
lemon. To re-establish suction, squeeze the drain in the palm of your hand with
your fingers until the inside walls of the drain touch. While maintaining
pressure, replace the plug. Slowly release your grip to re-establish suction.
The drain should remain concave or somewhat flat. It should not
be fully inflated. If the drain is not flat, the suction is not working.
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A Jackson-Pratt drain prior to emptying |
Empty drainage fluid into a measuring cup and record the amount of fluid.
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 While
maintaining pressure, replace the plug. Slowly release your grip to
re-establish suction. |
Hemovac
A Hemovac is a round drain with springs inside that must be compressed
to establish proper suction. To re-establish suction, squeeze the drain on both
sides until the drain appears to be flat. While maintaining suction, replace the
plug and release your grip.
Davol
This suction device has a rubber bulb on top of the drain that acts as
pump to inflate the balloon in the drainage bottle. To re-establish suction,
squeeze the rubber bulb with a continuous pumping motion until the balloon in
the drainage bottle is completely inflated. Quickly replace the plug in the
drain before the balloon deflates. The inflated balloon inside the drainage
bottle creates the suction.
Correcting problems with the drain
If the drain tube becomes temporarily obstructed or is not draining
properly, you may:
- Bend the tubing over your fingers.
- Gently squeeze the tube between your thumb and index finger, moving your
fingers along the tubing toward the suction bottle, to help dislodge the
obstruction or blood clot.
Call your physician if any of the following occur:
* The drainage suddenly stops (The drainage should decrease gradually, not
abruptly.)
* There's a sudden change in the color of the drainage.
- The drainage should gradually change from blood to a straw-colored fluid.
- Call if the drainage becomes bloody again or changes to a milky white fluid.
* There's an increase in redness or swelling around the insertion site of the
drain.
* You are unable to re-establish suction in the drainage system. Directions for
suture line care
Suture (incision) line care also is a clean procedure. Supplies do not need
to be sterile, but you must wash your hands thoroughly before performing the
procedure.
- Suture line care should be done twice a day (morning and evening after
emptying the drain).
- In a basin or cup, mix 1 part hydrogen peroxide with 2 parts saline
solution or distilled water (For example, mix 1/8 cup of hydrogen peroxide with
1/4 cup of saline solution or distilled water.)
- Moisten the cotton-tipped applicators with the diluted hydrogen peroxide
mixture.
- Using the moistened cotton-tipped applicator:
* Gently wipe over the suture line and once down each side.
* Wipe once down the middle of the incision, gently removing drainage and
crusting.
--If crusting is difficult to remove, do not remove it.
- After cleaning the suture line, swab a generous amount of antibiotic
ointment on a cotton-tipped applicator. Gently and evenly spread the ointment on
the suture line.
Signs of infection at the suture line
Following are signs indicating that there may be an infection at or around
the suture line. Notify your physician if you experience any of the following
symptoms:
- An increase in redness, tenderness or swelling of the suture line.
- Drainage from the suture line. (Occasionally, a small amount of bloody or
clear yellow-tinged fluid may drain. Notify your physician if it persists or if
it changes in consistency.)
- A marked or sudden increase in pain not relieved by the pain medication.
- White pimples or blisters at or around the incision line.
General signs and symptoms of infection
- A persistent elevation of body temperature greater than 100.5 degrees
Fahrenheit. (You should take your temperature daily, at the same time each day.)
- Sweats or chills.
- Skin rash.
- Persistent sore throat, scratchy throat or pain when swallowing.
- Persistent sinus drainage, nasal congestion, headaches or tenderness along
the upper cheekbones.
- Persistent dry or moist cough that lasts more than two days.
- White patches in your mouth or on your tongue.
- Nausea, vomiting or diarrhea.
- Trouble urinating: pain or burning, constant urge or frequent urination.
- Bloody, cloudy or foul-smelling urine.
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A
Hemovac drain prior to emptying.
Empty
drainage fluid into a measuring cup and record the amount of fluid.
While
maintaining pressure, replace the plug. Slowly release your grip to
re-establish suction.
A
Davol drain prior to emptying.
Empty
draining fluid into a measuring cup and record the amount of fluid.
Squeeze
the rubber bulb until the balloon in the drainage bottle is completely
inflated. Quickly replace the plug in the drain before the balloon
deflates.