Definition:
Patients after receiving breast surgery typically stay in the hospital for 3 to 4 days. The surgical site may be inserted Jackson-Pratt drains (J-P drains) to drain wound discharge. These J-P drains may not be removed yet while discharge from hospital. These drainages can improve 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.
 
Notice for self care:
  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 tissue fluid. Record the amount of fluid, color, and characteristic on a sheet. According to the recorded data, the doctor can make a decision to remove the drains or not.
  3. Steps (A~F) to empty J-P drains:
    1. Wash hands.
    2. Lift the stopper from J-P drains (Figure 1).
      109814a60daac86624927d2c98ceb103.png
      Figure 1 Lift the stopper from J-P drains.
       
    3. Pour fluid into the measuring cup. (Figures 2-3)
      73abfde0754f1f0aba481d7ded75a99c.png
      Figure 2 Pour fluid into the measuring cup.

      a6fc877b7ecbaccd4319d3f709b9898f.png
      Figure 3 Please do not to touch the bottle mouth to prevent contamination when pouring the drainage fluid.
       
    4. Put back the stopper in the J-P drains.
      b4d440a6499f618cc87f190c5428a158.png
      Figure 4 Put back the stopper in the J-P drains.
       
    5. Wash hands.
    6. Record the amount of fluid (Figure 5). Please record the drainage fluid amount every day. For example:
      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

      fe66d9a48c9d9132a909eb4b96c69785.png
      Figure 5 Record the amount of fluid.
       
  4. Fix the J-P drains appropriately by a clothespin. When changing position, pay attention to the J-P drains. Always keep the J-P drains unobstructed (Figure 6).
    53fec874fa1813d5253234ebe66a6bfd.png
    Figure 6 Please gently knead the drainage tube to prevent clot clogging and to assure smooth drainage.
     
  5. Avoid squeezing or tugging the J-P drains.
  6. Keep the drainage tube below the insertion site.
  7. If there are more than two J-P drains, then record them separately.
 
If you have the following situations, please return to hospital immediately:
  1. The color of the J-P drains becomes blood like and turbid, or the J-P drains have a bad smell.
  2. The amount of the J-P drains greatly increases or decreases all at a sudden.
  3. The J-P drains are broken, disrupted, or disconnected.
  4. An increase in wound exudate and skin swelling.
  5. The wound becomes red, swelling, hotness, pain, purulent discharge, bad smell, or the body temperature is over 38 Celsius or 101 Fahrenheit.
 
Reference
  1. He, J. J. (2016). Precautions for post breast cancer surgery care. Health World, 478, 40-42. doi:10.6454/HW.201105.0049
  2. Heller, S., Rezapoor, M., & Parvizi, J. (2016). Minimising the risk of infection: a peri-operative checklist. Bone Joint Journal. 98-B (1Suppl A), 18-22. doi:10.1302/0301-620X.98B1.36365
  3. Ouldamer, L., Bonastre, J., Brunet-Houdard S., Body, G., Giraudeau, B., & Caille, A. (2016). Dead space closure with quilting suture versus conventional closure with drainage for the prevention of seroma after mastectomy for breast cancer (QUISERMAS): Protocol for a multicentre randomised controlled trial. British Medical Journal open, 6(4), e009903. doi:10.1136/bmjopen-2015-009903
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