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Surgical Drains Explained

In most abdominoplasty procedures, the plastic surgeon will insert one or more surgical drains to help prevent a build up of fluid behind the abdominoplasty incision and in the area that was operated on. Each surgical drain is a clear tube that is placed through a very short incision below the main incision. This tube leads out of the body to a small bulb that is about the same size and shape as a hand grenade. 
Usually, your surgeon will have the drain tube exiting your abdomen through one or more incisions made at your pubic mound or sometimes at the ends of the abdominoplasty incision. Drains exit through separate holes made under the main incision. The drain collection vessels are often pinned to a gauze belt. You may have only one drain, or you may have three. Different surgeons have different preferences. Some surgeons want you to pin the drains below where they exit, which makes sense, but others don’t see a problem with pinning them higher. Each of the bulbs should be emptied a few times a day. Each time you empty them, you squeeze them before you seal them. This creates a negative pressure in the bulbs that helps a bit with the drainage. The drains have a small tab on them with a hole that allows you to pin them to your clothing, to a makeshift belt, or to your support garment. You can make a belt to pin them to by taking some gauze bandaging and tying a length of it around your waist. Some patients have suggested buying a few large pairs of cotton undies, “granny panties.” You can either clip or pin the bulbs to the panties. You can also wear two pairs of these big panties and slide the bulbs between them. You will be asked to measure how much fluid has drained every day. Your surgeon may give you a chart for this purpose. He or she may also tell you to call if your drainage exceeds a certain amount, changes to a very red colour, or starts to smell very bad. The fluid may be yellowish, brownish, reddish, or a mixture of those and there may be some solid bits floating around. Emptying each bulb is easy. First, squeeze your fingers along the tube from your body toward the bulb to “milk” the fluid in the tube into the bulb. Do this gently and do not pull on the tube. The bulbs usually have markings on the side so you can just hold them up and read the amount of fluid in them. If the bulbs don’t have markings, use a little measuring cup to see how much fluid is draining. Write down the amount for each drain on your chart, if you have one. The bulbs have a little flip cap on them, so just flip open the little lid and dump the liquid in the toilet. You can empty the bulbs into a paper cup and then into the toilet if you want. Then squeeze the bulb tight to make a new vacuum, and close the lid. Usually, you empty the bulbs two to three times a day. Don’t be surprised if one drain collects more fluid than the others or one is dry and the others still collect fluid. This can happen and does not mean anything. 
 
While the drains are in, shower or sponge bathe gently. Do not use perfumed soaps or old sponges or washcloths. The best bet is to use an antibacterial product such as Hibiclens or Dial Antibacterial liquid soap and your hands. An old sponge or washcloth, even one only used a few times can have some bacteria in it. 
 
And what should you do with those dangling tubes and bulbs during your shower? Some people wear a makeshift belt made from a length of gauze bandaging wrapped around the waist and tied. You can pin or clip the bulbs to your belt and shower hands-free. Some say they have made a makeshift “necklace” of gauze and clipped the bulbs to this so that they were more mobile while they washed. Or you can hang a plastic clothes hanger on the inner handle of the shower door or over the shower curtain rod and attach them to the hanger. However, remember they are attached or those drains are going to remind you painfully if you forget and turn suddenly or step out of the shower. 
 
How long you will have the drains in place depends on how much drainage you have. This is one reason you need to keep track of the amount that collects in the bulbs each day. The surgical drains may be removed in as little as 3 to 5 days or as long as 15 days or more, depending upon the amount of fluid you are draining. They may not all come out at once, since drainage may be uneven. Your surgeon may decide to remove one or two drains and leave one in place. Essentially, the surgeon removes the drain by pulling the tube out. This may or may not be uncomfortable. Some people say it feels as though you had movement in your bowels or air moving around as they snake out. Some describe a lot of pain that was over quickly, while others said it was just a very odd feeling. Once the drains are removed, you are another step closer to being completely healed with a nice flat tummy.

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