1. Nursing Instruction
  2. Overview
  3. General Surgery

【Major points】

  1. The purpose of indwelling J-P drains is to drain the wound exudate.
  2. When pouring the drainage tube, the drainage tube must be folded back first, and then open the lid to pour the drainage fluid.
  3. The drainage tube should be secured to clothing with a safety pin or tube clip, or placed in a pocket to prevent it from slipping during movement.
  4.  If the color of the drainage fluid turns red or the drainage volume suddenly increases,you must return to the doctor immediately.

Why do I need to place J-P drains？

Patients after receiving breast surgery typically stay in the hospital for 3 to 4 days. When you discharged from the hospital, JP tube will be with you. The surgical site may be inserted J-P drains to drain wound exudate. Placing a drainage tube will promote wound healing and prevent infection. Hence, patients should know how to take care of these drains at home. Depending on the condition of wound healing, the doctor will remove the drains at the proper time.

Who needs to use？

Those patients who just had breast surgery.

What should I prepare?

Measuring cup and recording paper.

Steps to empty J-P drains:
  1. Wash your hands.
  2. Floding the tube and lift the stopper from J-P drains(Figure 1).
    126b51a6a3757adb9f215ee24426d577.png
    Figure 1　 Floding the tube and lift the stopper from J-P drains
  3. Pouring fluid into the measuring cup.Do not touch the bottle mouth to prevent contamination when pouring the drainage fluid(Figure 2).
    d673ec33cbb6df1bbd500b2c6982ea20.png
    Figure 2　 Do not touch the bottle mouth to prevent contamination when pouring the drainage fluid
  4. Squishing the J-P ball and put the stopper of J-P drains back(Figure 3).
    172653c3dad1894240315e7ba0b59826.png
    Figure 3  Squishing the J-P ball and put the stopper of J-P drains back
  5. Wash your hands.
  6. Record the amount of fluid everyday . For example: (Table 1) (Figure 4)
    (Table 1)
    Date time amount of fluid (ml) color total amount / day
    10/29 0900 30 ml light red 30 ml
      1700 30 ml light red 30 ml

    35472b476cc0163acdf0a7c54dd36b53.png
    Figure 4 Record the amount of fluid 
 
 
What should I pay attention to?
  1. Keep the wound clean and dry, observe the condition of the wound daily (the signs of wound infection are the wound turning red, swelling, hotness, pain, purulent discharge, fever, etc.), and change the dressing by the doctor's order. 
  2. Empty the J-P drains daily when then fill up to half amount of drain fluid. Record the amount of fluid, color, and characteristic on a sheet. The doctor can make a decision to remove the drains according to the recorded sheet. 
  3. Fix the J-P drains appropriately by a safety pin. Avoid bending,pulling or falling off drainage tube when turning over or getting out of bed.If there is a blood clot in the tube,gently knead the tube to prevent blood clots from blocking the drainage tube and keep the drainage tube flowing smoothly(Figure 5).
    0eeaee58d1f970eebe3f0cc9f6863aaa.png
    Figure 5　 Gently knead the tube to prevent blood clots from blocking 
  4. Keep the drainage ball below the insertion site.Always pay attention to whether the drainage ball is in a flattened negative pressure state to maintain the drainage function.
  5. If there are more than two J-P drains,they should be recorded separately .
  6. If the drainage fluid turns red, becomes turbid, or has a peculiar smell, the drainage volume suddenly increases or decreases, the drainage tube or drainage ball is damaged,broken or slipped, or there is exudation around the wound, please return to  the doctor immediately.
 Reference
  1. Seol, J., Yoon, K. C., Park, J., & Kim, K. G. (2023). Design of an Automatic Jackson-Pratt Drain Auxiliary System for Postoperative Management Applications. Surgical Innovation, 30(2), 271-274.https://doi.org/10.1177/15533506221108303.
  2. Shima, H., Kutomi, G., Sato, K., Kuga, Y., Wada, A., Satomi, F., Uno, S., Nisikawa, N., Kameshima, H., Ohmura, T., Mizuguchi, T., & Takemasa, I. (2021). An optimal timing for removing a drain after breast surgery: a systematic review and meta-analysis. Journal of Surgical Research, 267, 267-273. https://doi.org/10.1016/j.jss.2021.05.031
  3. Yang, T.T., & Chi, H.C, .Nursing Care for a Breast Cancer Patient with Post-op Chemotherapy Induced Peripheral Neuropathy. Journal of Oncology Nursing, 21，57-68.https://doi.org/10.6880/tjon.202112/sp_21.05
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    Taipei Veterans General Hospital 
    No.201, Sec. 2, Shipai Rd., Beitou District,  3e72dadb9904d06fa0fb3744e4ed2612.png
    Taipei, Taiwan 11217, R.O.C.
    Tel: +886-2-2871-2121 #04
    • Smoking and chewing betel nut significantly induce oral cancer. Obesity will potentially increase the risk of breast cancer and colorectal cancer. Please control body weight and keep away from tobacco and betel nut.
    • Information provided above can’t overcome physician's treatment and replace physician patient relationship.
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