【Major points】

  1. The purpose of indwelling drainage tubes (J-P drains).
  2. Steps to empty drainage tubes.
  3. Drainage tube care principles.
  4. Learn to identify and manage abnormal conditions of drainage fluid.

The reason for placing drainage tubes(J-P drains)?
Patients after receiving breast surgery typically stay in the hospital for 3 to 4 days. These drainage tubes(J-P drains) may not be removed yet while discharge from hospital.The surgical site may be inserted drainage tubes (J-P drains) to drain wound discharge which can improve wound healing and prevent infection. Hence, patients should know how to take care of these drainage tubes(J-P drains) at home. The doctor will remove the drainage tubes(J-P drains) depending on the condition of wound healing during the OPD time.
 
The steps to empty drainage tube :
  1. Wash your hands.
  2. Unfold the drainage tube and open the lid.(Figure 1).
    126b51a6a3757adb9f215ee24426d577.png
    Figure 1 Unfold the drainage tube and open the lid
  3. Squeeze the drainage ball to pour the drainage into the measuring cup, do not touch the opening site while pouring the drainage fluid. (Figure 2)
    d673ec33cbb6df1bbd500b2c6982ea20.png
    Figure 2 Squeeze the drainage ball to pour the drainage into the measuring cup, do not touch the opening site when pouring the drainage fluid.
  4. After the drainage liquid is poured, the drainage ball needs to be flattened and then put back the lid. (Figure 3).
    172653c3dad1894240315e7ba0b59826.png
    Figure 3 After the drainage liquid is poured, the drainage ball needs to be flattened and then put back the lid.
  5. Wash your hands.
  6. Record the amount of fluid daily . 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 daily.
 
 
Drainage tube care principles:
  1. Keep the wound clean and dry, observe the infected signs(the wound turning red, swelling, hotness, pain, purulent discharge, fever, etc,)of the wound daily, and change the dressing followed by the doctor's order.
  2. Empty the drainage tube daily when it is filled up to half amount of drain fluid. Record the amount of fluid, color, and characteristic on a sheet which can be the reference for doctor to make a decision to remove the drainage tube.
  3. Fix the drainage tube on clothes or pocket appropriately by a safety pin. We need pay more attention to the drainage tube, keep unblocked and smooth drainage while changing position. (Figure 5)
    0eeaee58d1f970eebe3f0cc9f6863aaa.png
    Figure 5 Please gently knead the drainage tube to prevent clot clogging and to assure smooth drainage.
        4.Keep the drainage ball flattening to maintain good drainage function.
        5.Keep the drainage ball below the insertion site.
        6.If there are more than two drainage tubes,they should be recorded separately.
 
If you have the following situations, please return to hospital immediately:
  1. The color of the drainage tube becomes blood like and turbid,or the drainage tube have a bad smell
  2. The amount of the drainage fluid greatly increases or decreases suddenly.
  3. The drainage tube are broken, disrupted, or disconnected.
  4. An increase in wound exudate, gauze wet frequently or skin get swelling.
  5. The wound becomes red, swelling, hotness, pain, purulent discharge, bad smell, or body temperature is over 38℃ (100.4 Fahrenheit).

Reference
  1. Mamuyac, E. M., Pappa, A. K., Thorp, B. D., Ebert, C. S., Jr., Senior, B. A., Zanation, A. M., Lin, F. C., & Kimple, A. J. (2019). How Much Blood Could a JP Suck If a JP Could Suck Blood? Laryngoscope, 129 (8), 1806-1809. https://doi.org/10.1002/lary.27710
  2. Salihi, S., & Kızıltan, H. T. (2019). Does using Jackson-Pratt drain affect the incidence of sternal wound complications after open cardiac surgery? Turk Gogus Kalp Damar Cerrahisi Derg, 27 (1), 15-22. https://doi.org/10.5606/tgkdc.dergisi.2019.15659
  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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