Drain Removal

I've been going through the past postings and I have seen some stories that are a bit concerning around removal of drains prematurely.

As those *****ad my previous posting, I may have my last two removed tomorrow. I'm happy yet concerned at the same time as of course don't want to develop any complications.

I've googled on drains and I can't find any concrete guidance about removal. Some articles say 7 to 10 days regardless of fluid output. I've seen articles that said that they don't recommend drains as they can do more harm than good and create a pathway for infections.

I remember having this conversation with my Bariatric doctor and his response was he doesn't make a determination on whether to use one or not until he sees what develops during the procedure. Drains have there pro's and cons. I do remember he removed mine 7 days after surgery and it was still outputting fluid.

I'm definitely going to discuss with my plastic surgeon tomorrow during my appointment. But I thought I would see what you guys think.

Is Drain removal a timeframe thing or a fluid output? Did anyone not have a drain?

Thanks

My doctor removed based on output.  I can't remember the exact amount but by the times they were removed it still had some output but it was significantly less then his number.

Ms Shell

Hi! I can imagine with the recent events that you are concerned and rightly so. They are removed by some based on time and others based on output. I will say the vast majority remove them based on output and I have seen more times than I can count that they recommend they not be reomved before they are down to putting out no more than 30cc per day at least for a couple days. Some say 25cc, but most say 30.

I've seen very few breast augmentations use drains, but have yet to see any other procedures without drains. Just voice your concerns. Going in there informed about usual and customary procedures puts you an empowered position and less likely to have them do something they shouldn't. I'm sure he'll do what's best.

Let us know how it goes!! Good luck! Whatever happens, I hope it is pain-free!

Denise

 

Hi, I am 3 weeks post op and had 7 dains. 5 in my stomach and one in each arm for brachioplasty. Both arm drains and 4 stomach were removed 1 weeks post op and my last stomach drain will be removed tomorrow.

My surgeon will only pull a drain id it is putting out less than 20cc fo 3 consecuive days.

Also the color changes to a urine like color and that too is an indicator for them.

Drain removal criteria...definitely surgeon specific.
I have seen the gamut!
(RN for 24 years, 14 of those in the surgical ICU)

My own surgeon has a 3 week rule- regardless of output.
For him-- Risk of infection outweighs risk of fluid collection.

It is his belief that seromas happen. It is a happy cir****tance if it does not occur.
It did not happen to me with my abdomen.
But if it had, well, I guess I would have needed aspiration if it occurred after the 3 week mark.

During my preop visit for arms and breasts last week, he let me know I will not have drains.
Of course, he reserves the right to change his mind once he is in there!


But he is awesome and I have to trust.
I would love it if I did not have them.
I guess we will see.

Just have open communication at your appt.
Be informed. Express your concerns.
Talk about what you have seen here...I always do!

Listen to what he has to say.
And come up with a plan!
Gone are the days of passive patients.
Remember...You and your doc are a team.

Good luck!

 I hate my drain but I love it too. It saved me from going back in for surgery to evacuate my enormous hematoma. Most of the hematoma slowly liquefied and drained out into my bulb over a period of 4 weeks. Black blood. Which would have been sitting inside my body otherwise. 

My PS requires output of less than 30cc for a couple consecutive days, and I just yesterday got down to 25cc. Tonight will likely be another 25cc day so first thing tomorrow I'm gonna call him up to get this thing pulled! The color is also an important indicator, as mentioned already. If I'd been draining 25cc of dark stuff, he would leave it in. Now my drainage is mostly pee-colored which means it's serous fluid. 

How much are you draining from your remaining 2 drains? If it's around 25-30cc and light colored, he may wanna pull it, and I'd agree with that. If it's over 40cc I'd be sure to ask. 

He's the doctor and he knows what he's doing, yes. BUT you've gotta advocate for yourself, because if something goes wrong, YOU are the one who is gonna suffer. He might apologize but it's your body. 

I presume you're still on antibiotics? Infection stemming from having a drain in is something to consider but my PS said he's never had someone with a drain get an infection because he always has them stay on keflex as long as they have their drain. It prevents infection. Also keeping the drain site clean and covered will go a long way. Empty your drains on time. Don't let the stuff sit around in the bulb all day getting old. 

I was ready to fight my PS to keep my drain a few weeks ago and I'm glad I did keep it because that extra time I was getting rid of fluid that would've built up inside me, AND I wouldn't have been on antibiotics to prevent infection of those fluid pockets. Drains are infection risks but so are pockets of fluid and blood, which are bacteria breeding grounds. 

I'm obviously on the side of keeping drains if there's any doubt. But discuss it with your doctor. It shouldn't be any skin off his back if you leave them in and get them out later. He doesn't have to deal with the danged things. 

I've been on antibiotics since leaving the hospital Cefadroxil 500 Mg (twice a day for 14 days).

Below is a chart of my drainage. He Pulled #1 & 3 on Monday; therefore I still have #2 &4. #2 is Serous fluid, #2 is dark.

Will definately speak with him this afternoon. Thanks for the input.

Date & Time	1	2	3	4	Total
Total 11/24/2011	12	12	12	50	86
11/25/2011 - Morning	5	2	2	25	34
11/25/2011 - Night	10	5	5	25	45
Total 11/25/2011	15	7	7	50	79
11/26/2011 - Morning	5	10	5	25	45
11/26/2011 - Night	10	10	5	25	50
Total 11/26/2011	15	20	10	50	95
11/27/2011 - Morning	2	5	2	25	34
11/27/2011 - Night	10	10	2	25	47
Total 11/27/2011	12	15	4	50	81
11/28/2011 - Morning	10	10	5	40	65
11/28/2011 - Night		10		25	35
Total 11/28/2011	10	20	5	65	100
11/29/2011 - Morning		10		25	35
11/29/2011 - Night		15		30	45
Total 11/29/2011	0	25	0	55	80
11/30/2011 - Morning		10		25	35
11/30/2011 - Night					0
Total 11/30/2011	0	10	0	25	35

 

 Before my surgeon removed mine he looked at my log. i had started to empty mine 1 every other day because I was only getting 10 to 15 cc a day. He said that was great he removed mine when I was 3 weeks out. I have had no problems with them gone.

Best of luck when they are gone for good you will find it so much better to more around and sleep. 

I had two drains post pani removal and TT.  Both drains were pulled at my 8 day post-op appointment.  They never drained more than 15cc's per day the entire time I was home, and the last three days I had them they didn't drain more than 5cc's per day.  

I was so happy when those darn things came out!  I think I would have left in tears if he wouldn't have pulled them!

Definately seems surgeon specific, but most seem to go by output and let them run there course like Denise And me did a 6 week stint ourselves. Let your doc do his thing I guess but stay on top of things looking for a seroma and hopefully it works itself ok.

Bubba