Postoperative Drain Care Instructions
Patients having breast cancer surgery may be sent home from the hospital with one or more drains. The type of drain most commonly used is called a Jackson Pratt (or JP) drain. This drain consists of a small plastic reservoir bulb connected to a flexible drainage tube. Its purpose is to remove fluid from the surgical wound through mild suction. The JP drain stays in place for an average of 7-14 days (possibly longer), and can be removed in your surgeons’ office.
Carefully review these instructions on how to care for your JP drain at home. You should also ask your hospital nurse to review the steps of JP drain care prior to discharge from the hospital.
- The JP drain tubing is sutured into place. Pulling on it may cause discomfort. Your nurse will show you how to secure the JP drain so it will not pull and cause discomfort.
- Check the skin around the insertion site of the JP drain (and surgical incision) looking for signs of infection daily. Slight redness around the JP drain insertion site is not unusual. However, a large area of redness or tenderness around the JP drain insertion site may indicate a problem.
- JP drain care involves having a clean area to ‘empty and measure’ the JP drain; and washing your hands before and after drain care.
- JP drain care involves three important steps. One is measuring the JP drain output. Second is keeping the JP drain tubing from ‘clogging’. Third is maintaining an accurate record of the JP drain output.
Keeping the JP drain tubing from ‘clogging’. Before or after the JP drain reservoir bulb is emptied and measured…’milk or strip’ the JP drain tubing. This is done to prevent small clots from blocking the tubing. To ‘milk or strip’ the JP drain tubing, the motion is similar to curling ribbon for a package. Note: do not unplug the JP drain bulb from its’ suction position when ‘milking or stripping’ the JP drain tubing. To ‘milk or strip’ the JP tubing, use one hand to hold the JP drain tubing as close to the insertion point in the axilla as possible to secure the tubing. Using the other hand, squeeze the JP drain tubing using your thumb and forefinger. Applying firm pressure, squeeze the JP drain tubing from the axilla to the bulb.
Measuring JP drain output. Hold JP drain reservoir bulb upright. Remove the drainage plug to release suction. Turn the reservoir bulb upside down and gently squeeze the fluid into a measuring cup (which the hospital will provide upon discharge after surgery). Record the amount of drainage. To resume JP drain suction, squeeze the reservoir bulb from ‘side to side’ to remove the air, and while squeezing the bulb, reinsert the drainage plug.
Maintaining accurate JP drain output record. Measure JP drain output twice a day… in the morning and in the evening. Record the time, the amount of drainage, and color of drainage on attached sheet.
Additional Drain Care Tips
- Do not disconnect the reservoir bulb from the tubing to remove clots or rinse the inside of the bulb with water because this could increase the likelihood of infection.
- Dispose of the JP drainage (once it is measured) either down the sink or toilet.
- Try to wear clothes that are easy to get ‘on and off’ while the JP drain is in place (preferably button down or zipper front shirts).
- Bras (if worn) should be supportive but not too tight. Some women prefer bras with front closure (such as sports bra with front closure).
- The JP drain usually is removed when the drainage fluid is 30cc or less for 24hrs. (Note: this parameter may vary pending your surgeon, and if so, it will be clarified at the preoperative teaching session with your nurse as to when the range of motion exercises may begin after surgery).
- Range of motion exercises for the arm and shoulder on the side of surgery usually starts three (3) days after surgery (Note: this parameter may vary pending your surgeon, and if so, it will be clarified at the preoperative teaching session with your nurse as to when the range of motion exercises may begin after surgery).
Notify your surgeon if:
- You develop a fever of 100.5F or higher.
- There is increased redness or tenderness at your JP drain tubing insertion site or at the surgical incision(s).
- There is a large amount of leakage around the JP drain tubing insertion site.
- There is a marked increase in JP drainage output within 24 hours from the previous measurement; or the JP drainage output abruptly decreases or stops.
- JP drain falls out.
- JP drain reservoir bulb does not maintain suction (stays flat) after reactivating.
Proper JP drain care is essential to your physical recovery. Please contact your surgeons’ office if you have any questions or concerns.