Question about surgical drain - don't read if squeamish! Yes, I talked to surgeon!

[RoughCollie]

My son had surgery a week ago. He has a surgical drain in place. Today, when he removed his dressing, and the drain incision was bleeding. The blood was coming from around the drain, not through it.

 

I called the surgeon on call. I asked if I should, as usual, wash the incisions, put antibiotic ointment around the drain incision, and cover it with gauze. He said yes.

 

I said I was concerned because if blood can get out of DS's body, then germs can get in, and I wanted to make sure he didn't get an infection at that site.

 

The surgeon said there was no chance of getting an infection there, because that is what the drain prevents. This makes no sense to me. The blood was not coming from the drain and I made that very clear!

 

So does my plan, which the surgeon has already approved, sound like a good one?

 

I will call the doctor tomorrow, but he's never there. I'm not real impressed by the nurses at his office, for very good reasons.

 

What think ye?

 

Thanks,

RC

[Lara in Colo]

I would go in tomorrow and have it looked at (the office) just for peace of mind.

[mumto2]

I am not a medical professional but I did take carexof my mom after her mastectomy. That happened. When I investigated the tubing was clogged right by the incision. The surgeon said to take a pencil and use it to apply pressure and move the clot down into the drain. I would describe it as stripping it. Anyway I couldn't fit the pencil in between the clot and the incision, I had about a centimeter, but the surgical nurse next door was able to so we avoided a hospital run. The clot moved easy after the pressure was applied behind it. No more leakage after clot moved to drain. So look at the tubing carefully. They did remove the drain two days later.

 

I hope your ds heals quickly.

[AvasMom]

I agree with stripping it. We do this all the time with post-op patients and a clog is the main reason people will have leakage around a drain. We don't do it with a pencil but with our fingers. I've tried typing out how to do it but can't make it make sense. :-/ Can you google "stripping a surgical drain" and see if there is a You Tube maybe? Is it the type with a bulb at the end? Those are called Jackson Pratt (or JP) drains.

[RoughCollie]

Thank you for your help. I did look up how to strip a surgical drain. This one doesn't have a bulb at the end.

 

I had to take off the wound dressing and the drain dressing because he was bleeding again. Basically, the question is what clot? I used a pencil to hold the drain open (it looks like the end of a balloon where you blow it up), and saw nothing. Then I held the drain at the incision site and kind of smoothed it out, and a little bit of fluid came out (like watery blood).

 

I looked everywhere and couldn't see a clot. So I patched him back up, this time with 5 gauze pads on the drain.

 

Thank you very much for your help. I appreciate it more than I can say.

 

RC

 

Really, how could they send DS home without instructing me on this stuff. I told DS that when he goes to the doctor, everyone will probably laugh at how I bandaged him. It is effective, but it doesn't look like a professional did it, that's for sure. On the positive side, there is no infection. Of course, he's taking an antibiotic, so that helps. Also, so far I haven't hurt him at all -- that would do me in if what I had to do was painful for him.

[mumto2]

Obviously tlufkin actually knows what she is doing but the clot was obvious. The tubing was firm where the clot was as a I remember. If you can see up the tubing it must be something else. Sorry it didn't work.

[TranquilMind]

My son had surgery a week ago. He has a surgical drain in place. Today, when he removed his dressing, and the drain incision was bleeding. The blood was coming from around the drain, not through it.

 

I called the surgeon on call. I asked if I should, as usual, wash the incisions, put antibiotic ointment around the drain incision, and cover it with gauze. He said yes.

 

I said I was concerned because if blood can get out of DS's body, then germs can get in, and I wanted to make sure he didn't get an infection at that site.

 

The surgeon said there was no chance of getting an infection there, because that is what the drain prevents. This makes no sense to me. The blood was not coming from the drain and I made that very clear!

 

So does my plan, which the surgeon has already approved, sound like a good one?

 

I will call the doctor tomorrow, but he's never there. I'm not real impressed by the nurses at his office, for very good reasons.

 

What think ye?

 

Thanks,

RC

 

I'd go too. I had one after an appendectomy and nothing bled at all. Fluid just kept coming until it got more and more clear and it was done, but that was out the tube! Not around the incision. That should not be happening.

[RoughCollie]

Well, I'm pretty inept when it comes to this stuff, and I kept thinking that just because I don't see a clot doesn't mean it isn't there. Of course, I didn't mention that to DS -- when I talk to him, I'm upbeat and confident. Poor kid was so alarmed by all this. His brothers wanted me to take him to the ER, and that didn't help DS's anxiety at all, which is why I called the surgeon.

[EthiopianFood]

Doctors are so stupid sometimes. :glare: Keep talking until someone will listen. I'm sure it is something very easy to fix by a trained nurse. You just want to get it done before the antibiotics are done, I would think.Good luck!

[melissad2]

Any chance it's a penrose drain?

 

http://en.m.wikipedia.org/wiki/Penrose_drain#section_3

[RoughCollie]

You know, it might be a penrose drain. That's what it looks like. It's a yellowish looking, latex or similar, soft tube with no bulb at the end of, and it is tacked in place with a couple of stitches.

 

Here's the info I was given about the drain: Your son has a drain. You can remove it at home after 2 days. I said, What? I'm not removing a drain! I don't know anything about it!

 

I called the surgeons office twice, and the nurses said DS had no drain, that I was mistaken. This despite my informing them that I had seen the drain. I was calm, polite, did not curse, and made no threats. I did, however, speak my mind very clearly. Besides the drain, I insisted that DS be provided with stronger pain meds, which the nurse disagreed with because of addiction concerns that were not warranted. I know enough about drug addiction to know it doesn't apply in this case, and why. I shared my knowledge with her.

 

20 minutes later, a third nurse called me and said that the doctor would remove the drain on April 3, when DS goes to have his stitches removed. She also called in a prescription for a stronger pain med.

 

I am going to call the surgeon's office again this morning. Hopefully, I will talk to nurse #3. Probably will because I am pretty sure that nurse #1 and nurse #2 are afraid to talk to me again. I would be if I were them.

 

The main problem I have with health care providers here is that they treat people like they are stupid. I'm not used to that, and I won't put up with it. The people I know who live here are not bothered by this ... they do whatever the docs say without question and they *never* get sufficient information about their health problems. The patients don't care because the doctors know everything so they don't have to. That is really odd to me. The culture here, in general, is authoritarian to the max!

[melissad2]

Drainage from around a penrose is usually fine, as long as it is not yellow, green or foul smelling. They are placed to keep the wound from closing too soon and to allow drainage.

[RoughCollie]

Yes, that's what it must be then, Melissa. This wound is usually left open and is packed so it can heal from the inside out. The surgeon closed the wound and inserted the drain instead. I carefully looked for signs of infection, and there were none.

[AvasMom]

It does sound like a penrose. I found some instructions for you here http://www.ehow.com/how_5699763_care-patient-penrose-drain.html but I would probably call and clarify whether they want you to leave it, pull it, etc. Your instructions were really inadequate. :( We deal with JPs almost exclusively so I'm not much help with a penrose but my understanding is that they require even less maintenance than a JP so thats good. :)

[Tammyla]

I'm squeamish, and didnt read because of it. :grouphug: