Drainage and wearing compression garmet after panniculectomy

I had a panniculectomy on November /30/2009, today I am 5 weeks out and feeling great. I still wear my compression binder 24/7 and still have the two original drains,  the drain output is on average 47 cc per day for each of them, I know that most PS will take them out when the output gets to 30cc per day, I was wondering if there is any issues with having them for so long and if my output will ever get to 30 cc or less, I was also wondering how much longer I need to wear my binder, I think the PS told me that for at least 6 weeks. Thanks for any comments on this.

I had my panniculectomy on November 27 and, when I got my drains out 12 days later, it was longer than most folks have them in.

I think you should be more concerned about why you are drainining that much this far out than the compression garment, personally.

However, that being said, I have been wearing stage 2-type compression garments around the clock since I had the drains removed.  In my case, that means extra firm control Spanx and the like.  But you can't move to the stage 2 garment until the drains are out.

Wow, I am realy surprised at the amount of drainage after so long and I hope that you get them out soon!  The drains were probably the most irritating part of the entire process.  I would have had a horrible time having those drains in as long as you have!  I think I might ask your PS about the amount of fluid.

I am at 7 weeks and I wear my compression garment to bed and most of the time.  I have gone a full day without it a few times - shopping, social events, etc.  I am still at the place that it feels very comforting to have it on.

Best of Luck!

I had one drain after my LBL for just over 5 weeks.   My PS said that some folks are just juicer than others ;)

Dear Lacatana,

Most drains come out within 1-2 weeks after the majority of panniculectomy procedures. Simply put, the skin and fat need to seal back to the muscle. When this sealing process is slow, the outputs remain high.

30cc per day per drain has become the magic number for most surgeons. Once the drain output is less than 30ccs/24hrs, the body should be able to absorb that fluid and prevent a seroma from forming.

5 weeks is a long time to have drains, honestly. I think the biggest concern is infection. A drain is a two-way street... although fluid comes out, certainly bacteria can get in. With proper drain care, the chance of infection is low.

Just curious, what is your BMI?

Are you doing to much activity?

I would recommend to wear the binder as much as possible and refrain form too much activity in order to minimize your fluid outputs.

Sincerely,

Joshua Kreithen, M.D.
Board Certified Plastic Surgeon, Sarasota Florida
www.lakewoodranchplasticsurgery.com

Hi Dr. Kreithen, thanks for your response, my bmi pre op was 32.7 and post op was 31.2, I had 15 pounds of fat and skin removed so I am sure there was plenty of fat there. I am currently at 210 pounds, I am a male and stand 5 foot 9 inches. I am not exercising but I do go out and walk around etc. I am trying to understand the relationship between activity and drainage, I get mixed feedback, activity is good but yet causes more fluid output, If I reduce activity will my fluid output go down? Will I then get to 30cc and get the drains pulled out? 

Thanks for your input, I appreciate having a professional opinion on the subject.

Sincerely

LaCatana
 

I had one drain in for 4 wks after my TT, but the other one stayed in for 6 wks!  It was putting out about 60 ccs a day until the last 2 wks, then it starting slowing down.
  I wore my binder every day until the last drain came out, then switched to some other type 2 garments.  I took the binder off at night after 2 wks. and don't sleep in any kind of garment now.
  Good luck, I hope your drains come out soon!

Lacanta ,
From A Nursing side ........
You want to move and gradually increase activity ...
1.TO PREVENT BLOOD CLOTS ..
That is why you will always hate your post op nurse she wants you up out of bed and walking.
2.The fluid will just be pooling at your surgical site because you are sitting.
When you are up and walking and doing activity you are distributing your fluid all over and your body can reabsorb it and your kidneys will flu**** out .When you decrease your activity it has no where to go but the only outlet it has the drains....
I hope this helps you!!!

Dear Lactana,

I would really recommend minimal activity until the drain output is decreased. Too much activity will increase the shear forces inside your abdomen and lead to more fluid creation.

I'm not saying bedrest, but try to minimize any activities that may lead to your abdomen moving excessively.

Also, wear the binder as tight as you can tolerate.

Good Luck,

Dr. Kreithen