Living with a surgical drain after a mastectomy

MedlinePlus gives one list of reasons to contact your surgeon, without ranking them.

Contact your surgeon if your temperature is 100.4°F (38.0°C) or higher, if the stitches holding the drain come loose or go missing, if the tube falls out, if the skin where the tube comes out is very red, if there is drainage from the skin around the tube site, if tenderness and swelling at the site increase, if the drainage is cloudy or has a bad odour, if drainage from the bulb increases for more than 2 days in a row, if the squeeze bulb will not stay collapsed, or if the drainage stops suddenly after the drain has been steadily putting out fluid.

A small amount of redness is normal. That last item catches people out, because a drain that stops seems like good news.

A closed suction drain removes fluid buildup after surgery or infection. It is made of a thin rubber tube and a soft, round squeeze bulb described as looking like a grenade.

You may hear staff call it a Jackson-Pratt, or a JP drain. Same thing.

Knowing the mechanism helps: the squeezed bulb creates gentle suction, which is what draws fluid away from the surgical area instead of letting it pool.

The single most common complaint is the weight of the bulb pulling on the tube where it enters your skin.

There is a designed solution for this. The bulb has a plastic loop that can be used to pin it to your clothes. You can also buy garments made with pockets for drainage bulbs.

Nothing should be dangling. A pinned or pocketed bulb hurts far less than a swinging one.

Some people manage with what they already own — a dressing gown with pockets, a lanyard, safety pins on the inside of a loose shirt. Whatever keeps the bulb supported at roughly the level of the drain site is doing the job.

Emptying is a routine, and so is the paperwork. Measure the drainage in a cup and write down the amount of fluid, plus the date and time, each time you empty it.

Expect to empty it frequently at first. As the drainage slows down, it may drop to once or twice a day.

The record is not busywork. It is the one measure of how the drainage is changing over time, so bring the log to every appointment and keep it going until the drain is out.

Keep the area where the drain enters your skin clean and dry.

If you have a dressing, change it using sterile technique with clean gloves. Each time, look at the site for any new redness, swelling, bad odour or pus.

MedlinePlus does not put a figure on how long a drain stays in, and neither will we. It varies with the surgery and with how quickly the drainage slows, so the person to ask is your surgeon.

That is a short chapter, even though it does not feel short while you are in it. Sleeping is the hardest part for most people, and finding a workable arrangement — pillows, a pinned bulb, a position that keeps the tube slack — is worth some trial and error in the first couple of nights.