Many women consider grenade-shaped surgical drains to be one of the most annoying aspects of recovery, but drains perform a necessary function. In the following guest blog, Dr. Aldona Spiegel explains why drains are necessary after any type of breast reconstruction.
Questions about surgery drains are some of the most frequently asked topics about recovery from reconstructive surgery after breast cancer. Patients usually don’t like these pesky appendages which can be cumbersome but ultimately are your friend (hopefully not for too long).
The reason why drains are necessary in some surgical procedures is that the body has a tendency to release lymphatic fluid and a small amount of blood in areas that have been recently operated on during the process of inflammation and healing. When this is a small amount of fluid the body can reabsorb it without any problems, but if this volume of fluid is more than about 25 ml per day the fluid can accumulate and form a seroma. This is why it is important to measure the total amount of fluid that is generated through each drain every day so that we can tell whether the drain is ready to be removed. Remember that the more activity you are doing the more your drains will typically drain as movement increases the amount of fluid that is released.
The drain tube is made of a smooth silicone material that is easily removed in the office. It is sutured in place with a small black stitch and there is a black dot on the drain indicating where it should be in relation to the skin. The dot is generally at the position of the stitch, if the black dot on the drain is more than 2 inches away from the skin that means the drain has been pulled out and needs to be removed.
The color of the liquid collected in the drain bulbs can range between a clear liquid to a pink or a blood tinged one. The drain needs to be stripped approximately 3 to 4 times a day to prevent it from getting clogged. The nurses will have shown you how to do this before you leave the hospital. The fluid is emptied from the drain bulb into a measuring cup and the volume recorded in the drain output sheet. Typically two drains are used per area in order to make sure that if one drain gets clogged the other one is functional.
The drain bulb has a loop which can be used to put on a loose belt or secure with a safety pin to clothing. We have seen several very inventive ways of securing drains! It is important to be mindful as not to snag the drains because they can be accidentally pulled out, paying specific attention to them when showering to make sure they are secure.
Aldona Spiegel, M.D. of The Center for Breast Restoration provides breast reconstruction, including perforator flaps, in Houston, TX.