Post-Op Care Guidelines
Nip & Tuck Plastic Surgery

The Jackson-Pratt drain system is made of a soft plastic bulb, a catheter, and a drainage outlet cap. The other end of the drain is inside of your body, just beneath the skin. The purpose of the drain is to draw out fluid that would otherwise collect under the skin. In order for the system to work, the bulb should be compressed at all times except when you are emptying the drainage.

We typically keep the tube in for 1-2 weeks, however each case is very individualized. It is important for you to record your output daily and bring records with you to all your follow-up appointments so we can determine if it is time to remove your drains.

Caring for your drain at home involves the following:

1. Stripping the tubing to help move clots.
2. Emptying the drains several times a day and recording the amount of drainage on the JP DRAIN OUTPUT RECORD.
3. Caring for your insertion site (the area where the catheter enters your skin).
4. Recognizing when there is a problem.

These steps will help move clots through the tubing and promote the flow of drainage. Do this before you empty and measure your drainage.

1. Wash your hands thoroughly with soap and water. Dry them thoroughly.
2. At the point closest to the insertion site, pinch and hold the tubing between the thumb and forefinger of one hand.
3. With the thumb and forefinger of your other hand, pinch the tubing right below your other fingers. Keeping your fingers pinched; slide them down the tubing as far as they will reach. If there is still tubing between the fingers of your lower hand and the bulb, keep the lower fingers pinched and release your upper fingers. Pinch the tubing right below the fingers of your lower hand. Slide them down the tubing as far as they will reach. Repeat until you reach the bulb. You may want to use alcohol swabs to help you slide your fingers down the tubing more easily.
4. Repeat steps as necessary to push clots from the tubing into the bulb. If you are unable to move a clot into the bulb, call your doctor’s office.
5. The fluid may leak around the site if a clot is blocking the drainage flow. If there is fluid in the bulb and no leakage at the site, then the drain is working in spite of what appears to be a clot.

You will need to empty your Jackson Pratt in the morning, lunch and afternoon.

Equipment Needed:

1. Measuring container2. JP drain output record

Steps to Follow:

1. Prepare a clean area on which to work and gather your equipment.2. Wash your hands thoroughly with soap and water. Dry them thoroughly.3. Unplug the stopper on top of the Jackson Pratt. This will cause the bulb to expand.4. Do not touch the inside of the stopper or the inner area of the opening on the bulb.5. There are hash lines on the drain with measurements in mL (typically up to 50mL), record the amount.6. Turn the Jackson Pratt upside down, gently squeeze the bulb, and pour the contents into the measuring container (Figure 2).7. Turn the Jackson Pratt right side up.8. Squeeze the bulb until your fingers feel the palm of your hand.9. Continue to squeeze the bulb while replugging the stopper.10. Check to see that the bulb remains fully compressed to assure a constant gentle suction.

11. Pin the collar of your Jackson Pratt securely to a piece of your clothing. Do not allow your drains to dangle. A “fanny pack” or loose belt bag may be helpful to hold the drain.12. Check the amount of drainage in the measuring container.13. Record this amount on your sheet.14. Empty the drainage down the toilet and rinse the measuring container with water.15. At the end of each day, add the total amount of drainage for the 24-hour period and record it in the last column of the drainage record.16. If you have more than one drain, measure and record each separately.

Once you have emptied the drainage, wash your hands again. Check the area around the catheter insertion site.

Look for tenderness, swelling, or pus from the insertion site. If you have any of these or a temperature of 101° F (38.3° C), you may have an infection. Call our office at 404-777-8825. Sometimes the drain c auses redness the size of a dime at the insertion site. This is normal. Apply antibiotic ointment around the tubing and dress the wound with a piece of gauze attached by tape.

1. BULB NOT COMPRESSING

• Not squeezed tightly enough
• Stopper not closed securely
• Suction catheter dislodged

WHAT TO DO?

• Compress the bulb

2. NO DRAINAGE, SUDDEN DECREASE IN DRAINAGE

WHAT TO DO?

• Follow instructions for tub stripping

3. CATHETER FALLS OUT FROM INSERTION SITE

• Rarely happens, but if it does, place a dressing over the site and call our office during normal business hours

4. REDNESS GREATER THAN THE SIZE OF A DIME, swelling, heat, or pus around drain insertion site

• Take your temperature & call our office, this could be an infection.
• Keep insertion site clean and dry by washing with soap and water and gently patting it dry.

• Redness, swelling, and drainage around the area where the tube exits the body.
• Immediate refilling of the bulb with drainage/ blood after emptying.
• Inability to flatten the bulb or drainage bottle.
• The tube falls out.
• A fever.

Helpful Hints:

• It is recommended that you safety pin the drainage bottle to your clothing during the day and to your night clothes during the night. Allow enough slack to prevent the tube from being pulled out.
• Be very careful not to puncture the tubing or the drainage bottle with the safety pin—use the plastic tab on the drain to put the pin through.
• Attach the container below the level of the tube exit site.
• Be very careful with daily activities so that you do not dislodge the tubing.