Drains

Question 1

What are 3 indications for surgical drains?

Answer 1

• Dead space cannot be obliterated
• Fluid accumulation
• Infection

Question 2

What is a disadvantage to surgical drains?

Answer 2

Increased risk of secondary infection.

Question 3

What are 3 ways to try to reduce dead space?

Answer 3

• Tacking sutures
• Drains
• Compression bandage

Question 4

Drains should never exit through where?

Answer 4

Incision line

Question 5

Drains should not lie where?

Why?

Answer 5

• Directly under the suture line.

- Increased risk of dehiscence.

Question 6

Tacking drains with what is discouraged?

What is preferred?

Answer 6

• Tacking drain with buried sutures.

- Percutaneously placed sutures which can be removed prior to drain removal are preferred.

Question 7

What are 2 main categories of drains?

Answer 7

• Passive

- Active

Question 8

Which category of drain depends on gravity and capillary action to move fluid?

Answer 8

Passive

Question 9

Which category of drain requires a suction device to pull fluid from the wound?

Answer 9

Active

Question 10

With which category of drain is the surface area of the drain important?

Answer 10

Passive

Question 11

Passive drains must exit dependent of where?

Answer 11

Dependent of wound

Question 12

Which is preferred, a single exit site or two exit wounds?

Why?

Answer 12

• Single exit site

- Decrease risk of ascending infection.

Question 13

The drain exit must be kept what 2 things?

Why?

Answer 13

• Clean and dry

- Minimize maceration of surrounding skin.

Question 14

A bandage is applied in most instances for what purpose?

Answer 14

To absorb fluid coming from wound.

Question 15

What type of drain consists of soft latex tubing that collapses easily?

Answer 15

Penrose drain

Question 16

Do Penrose drains conform well to wounds?

Answer 16

Yes

Question 17

What is sometimes done to a Penrose drain that may decrease effectiveness by reducing surface area?

Answer 17

Fenestrating the drain.

Question 18

A fenestrated Penrose drain modified with gauze strip inside is known as what?

Answer 18

Cigarette drain

Question 19

The wicking action of gauze inside a cigarette drain may improve what?

Answer 19

Effectiveness of drain

Question 20

What is increased with a double exit Penrose drain compared to a single exit?

Answer 20

Increased risk of infection.

Question 21

How should a double exit Penrose drain be removed?

Answer 21

Prep skin, apply traction to drain, cut suture, cut drain below exposed portion, pull remaining portions as with single exit.

Question 22

Which has greater efficiency, a passive or active drain?

Answer 22

Active drain

Question 23

There is a decreased risk of what with active drains?

Answer 23

Decreased risk of macerating surrounding skin.

Question 24

Is risk of infection lower with passive or active drains?

Answer 24

Active drains

Question 25

What is the primary cause of active drain failure?

Answer 25

Obstruction

Question 26

Active drains enhance what?

Answer 26

Healing

Question 27

Fenestrations made in drains should not be greater than what length?

Answer 27

Should not be more than 25% of circumference of drain.

Question 28

The exit site of an active drain can be where?

Answer 28

Wherever it is convenient to secure the suction canister.

Question 29

Why must the exit hole of an active drain be kept small?

Answer 29

To minimize air leakage.

Question 30

What type of closure is necessary for an active drain?

Answer 30

Airtight skin closure

Question 31

With an ingress/egress system, do they share the exit hole or have separate holes?

Answer 31

Ingress drain should have separate access.

Question 32

What is the ingress drain used for?

Answer 32

Only used for flushing.

Question 33

What should be done to the ingress drain when not in use?

Answer 33

Should be capped off.

Question 34

Are ingress/egress systems used with active or passive drains?

Answer 34

Both

Question 35

What do you NOT do with the egress drain?

Answer 35

Do NOT inject into egress drain.

Question 36

What are 2 determiners for when a drain is typically removed?

Answer 36

• Usually 3-7 days

- Drainage decreases

Question 37

Does a drain typically stop completely within 3-7 days?

Answer 37

No

Question 38

The drain should be removed if what happens?

Answer 38

Discharge becomes serous or serosanguineous.

Question 39

If taking a sample for a culture, where is a good place to take it from?

Answer 39

Cut off/swab end of drain from deepest part of wound after removal.