Breast Cancer Surgery – Drain Care
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This video is to complement the Your Journey through Breast Cancer Surgery booklet.
You should have received this booklet from your healthcare team.
If you have not received a booklet please contact your healthcare team.
You might have a Jackson Pratt drain (also called a JP drain), or a Blake drain.
Both of these drains use suction to drain the fluid that collects under your incision (or surgical cut) after breast surgery.
You may have one or more drains that are placed under the skin near the armpit at the time of surgery.
The drain has a soft, plastic bulb with a removable plug and flexible tubing.
The bulb and most of the tubing is outside of the body.
A small part of the tubing is under your skin and has holes for drainage.
The tubing leaves the body near the armpit.
This is called the insertion site or drain site.
The tubing is held in place by a suture (or stitch).
When the bulb is flat with the plug in place, it creates suction to remove the build-up of fluid under the incision.
The bulb will expand as it fills with fluid.
Keep the bulb as flat as possible (or primed) and empty it when it is more than half full.
The fluid from the drain may be red at first but as your incision heals, it will turn pink or yellow and become more watery.
The amount of fluid that collects in the drain may be different each day but should lessen over time.
It is normal to see air bubbles and pieces of stringy, white, or bloody tissue in the bulb or tubing.
Emptying your drain:
Empty the bulb every 8 hours or whenever it looks half full.
To empty the drain:
Wash your hands with soap to help prevent infection.
Unpin the drain from your clothing while supporting the bulb so the tubing doesn’t pull against your skin.
Be sure to close the pin.
Remove the plug.
Turn the bulb upside down and squeeze out the fluid into a measuring container.
When the bulb is empty, squeeze it flat and put the plug back on the bulb.
This step creates suction by removing air from the bulb.
Don’t rinse out the bulb!
Using the tab, pin the drain to your clothing below the insertion site.
Don’t let the drain hang freely from your body as it may get caught on something or get pulled out.
Measure the fluid in the container then write down the amount of fluid collected and the date and time it was collected in your drainage record.
It is important to write down this information as it helps your healthcare team know when the drain is ready to be removed.
See ‘drainage record’ in the At Home section in your booklet.
Flush the fluid down the toilet.
Rinse out the measuring container with soap and water.
And wash your hands.
Showering and comfort measures:
You can shower with your drain 24 to 48 hours after surgery.
But before getting into the shower, pin the drain to a belt or similar item around your waist.
You don’t need to cover the insertion site but try to avoid spraying water directly on it.
Don’t use soap directly on your drain or the insertion site.
After you shower, cover the insertion site with a dry gauze dressing or leave it open to the air.
Pin the drain to your shirt or pants.
Shirts with buttons or zippers are the best to use when you have a drain following breast surgery.
You can also put the bulb in a shirt pocket or the pocket of a hoody.
If you prefer to hide the drain, wear a hoody inside out.
Just make sure the bulb is below the insertion site.
You can lay on the drain area if it is comfortable.
You can also use your arm on the same side of the drain for light daily activities.
This will help you to heal and prevents the arm from stiffening up.
When to call your Healthcare team:
Call your healthcare team if you have: bright red bleeding that doesn’t stop or signs of an infection.
Signs of an infection include a temperature over 38.0 °C, smelly or creamy-coloured fluid, and worsening redness or swelling around the insertion site.
A little redness around the insertion site is normal and doesn’t mean you have an infection.
If the bulb doesn’t stay flat, this could be a sign of a leak.
Make sure the plug on the bulb is firmly in place.
If the plug doesn’t stay closed, try putting a piece of tape over top of the plug to hold it in place.
If the bulb still won’t stay flat, call your healthcare team.
This is not an emergency, but the suction won’t work if the bulb doesn’t stay flat.
Don’t worry if the drain comes out a little and the stitch is still in place.
But don’t push the drain back into your body.
Sometimes the drain may come all the way out or it is pulled out by accident.
If this happens, cover the insertion site with a clean gauze and call your healthcare team.
Even if the drain comes out, there may still be fluid draining from the insertion site.
Change the gauze regularly until you see your healthcare team.
You don’t need to clean the insertion site and you can still shower.
Milking your drain
If the tubing gets clogged, the suction will stop working.
Your tube might be clogged if:
You see something blocking the tube so the fluid can’t drain.
You see fluid leaking around the insertion site.
You don’t think the suction is working.
Or there is suddenly much less fluid draining.
Milk the tubing to help prevent it from clogging with small pieces of tissue or clots.
You can milk the drain on your own but you may find it easier to have someone help you.
To milk the drain:
Wash your hands and put 2 drops of any body lotion you have at home on the fingertips of one hand.
Using the hand without lotion, pinch the tubing firmly with your thumb and forefinger near the insertion site to hold the tubing in place.
Use the thumb and forefinger on the hand with lotion to squeeze and slide down the tubing half way to the bulb, keeping the tubing pinched.
The drain tubing is strong and can be stretched during this procedure.
Bring the hand without lotion above where the tubing is pinched.
Repeat the previous step to milk the lower half of the tubing.
Check to see if the fluid is moving down the tubing towards the bulb.
If not, the tubing may still be plugged.
Repeat the previous steps.
If you can’t remove the blockage after milking the tubing 2 to 3 times, and the drain doesn’t appear to be working, call your healthcare team.
Removal of your drain
Your surgeon or nurse will tell you when the drain can come out.
Drains usually come out when they are draining less than 25-30 mL in 24 hours or in 1 to 2 weeks after surgery.
Drains are often removed during a follow-up appointment with a member of your healthcare team.
Many patients worry that having the drain removed will be painful or hard to remove.
It usually doesn’t hurt and is easy to remove.
The doctor or nurse will first tell you what they are going to do.
They will then clean the area, cut the stitch, remove the plug in the bulb and gently but firmly pull the drain out.
You may feel a pulling sensation but it doesn’t last long.
The doctor or nurse may ask you to take a few deep breaths to help you relax before the drain is removed.
They will cover the hole where the drain was with a light gauze.
Keep the gauze on for 24 hours as some fluid may still drain after the drain is removed.
If the gauze becomes soaked with fluid, wash your hands, remove the gauze and apply a new one.
The hole where the drain was should heal and close over the next few days.
We hope this video about your Jackson pratt or Blake drain has been helpful in your journey through breast cancer surgery.
Remember to call your healthcare team if you have any questions.
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