What is abscess drainage?
Wound drainage is a medical procedure that involves intentionally placing a drain (a tube) into or near a wound to remove excess fluid, blood, or pus that may accumulate in that area. This technique is used in specific cases when the wound is at a higher risk of developing complications or delayed healing due to fluid accumulation.
Several situations in which wound drainage is done:
Postoperative drainage
After certain surgical procedures, such as abdominal or orthopedic surgeries, drains may be placed to prevent the accumulation of blood or fluid at the surgical site. These drains help reduce the risk of complications such as hematoma formation, fluid buildup, or infection. They are typically removed once the drainage reduces to an acceptable level.
Abscess drainage
When an abscess, which is a localized collection of pus, forms within a wound, it needs to be drained to facilitate healing and prevent the spread of infection. This is often done through incision and drainage (I&D) procedures, where the abscess is opened and drained to remove the pus. A drain may be left in place for a short period to enhance further drainage.
Chronic wound drainage
Certain types of chronic wounds, such as pressure ulcers, diabetic foot ulcers, or infected surgical wounds, may heal slowly and may have excessive fluid or exudate. In these cases, drainage techniques like negative pressure wound therapy (NPWT) may be employed. NPWT involves the application of vacuum through a specialized bandage, which helps remove excess fluid, promote blood flow, and accelerate wound healing.
Lacerations or traumatic wounds
Deep or complex wounds or wounds resulting from an accidents or trauma may require drainage to prevent blood or other fluids from collecting. This helps reduce the risk of infection and promotes proper wound healing.
What should patients know about wound drainage
Purpose: The primary goal of medical wound drainage is to remove excess fluid, blood, or pus from the wound area. This helps promote healing, prevent complications, and reduce the risk of infection.
Procedure: Patients should understand the specific drainage procedure that will be used in their case. This may involve the placement of drains, such as tubes or catheters, or the use of specialized dressings or negative pressure wound therapy (NPWT). Patients should have a clear understanding of how the drainage device functions and how to care for it.
Duration: The duration of drainage may vary depending on the type and severity of the wound. Most drains are temporary and will be removed by a health care professional when the drainage is reduced to an acceptable level.
Care and maintenance: Patients should receive instructions on how to care for the wound drainage device or dressing. This includes information on proper cleaning techniques, changing dressings, securing drains, and monitoring drainage output. It is important to follow these instructions to prevent infection and ensure effective drainage.
Signs of complications: Patients should monitor for signs and symptoms of potential complications related to wound drainage. This includes increased pain, excessive bleeding, worsening redness or swelling, unpleasant odor, or signs of infection such as fever or pus formation. If any of these symptoms occur, patients should promptly contact their healthcare provider.
Follow-up appointments: Patients should understand the importance of follow-up visits to their healthcare provider to monitor the progress of the wound and the effectiveness of the drainage. These visits allow for the assessment of the wound and adjustments to the treatment plan if necessary.
Emotional support: Dealing with a draining wound can be emotionally challenging. Patients should be aware that it is normal to feel frustrated, upset, or worried about the appearance and healing of the wound. Open communication with healthcare professionals and seeking emotional support from loved ones or support groups can help cope with these feelings.
Equipment used in wound drainage
Several types of equipment can be used in wound drainage procedures, depending on the specific technique being used and the characteristics of the wound. Here are a few common examples of equipment:
Drainage Tubes
Drainage Tubes also known as drains or catheters, are flexible tubes that are inserted into or near the wound to facilitate the removal of fluids. These tubes come in different sizes and shapes, such as Penrose drains (soft rubber tubes) or Jackson-Pratt (JP) drains (thin silicone tubes). Drainage tubes allow fluid to flow from the wound into a collection device or dressing.
Collection devices
Collection devices are containers that receive, and hold discharged liquid. They are usually attached to the end of the drainage tube.
Negative Pressure Wound Therapy Devices (NPWT)
NPWT devices are specialized systems used in negative pressure wound therapy. These systems consist of a vacuum pump or suction unit, tubing sets, and dressing kits. The vacuum pump applies negative pressure to the dressing, facilitating fluid removal, increasing blood flow, and improving wound healing.
Irrigation solution and irrigation equipment
For wound irrigation (flushing) procedures, sterile solutions are used to clean the wound and remove debris or bacteria. Common irrigation solutions include sterile saline or antiseptic solutions. Irrigation equipment may include syringes, irrigation vessels or specialized appliances.
Bandages and absorbent materials
Various bandages and absorbent materials can be used for wound drainage: gauze, foam compresses, alginate linings or superabsorbent compresses.
It is important to note that the specific equipment used may vary depending on the preferences of the healthcare professional, the specific procedure, and the available resources. The healthcare team will choose the most suitable equipment for the drainage needs of everyone’s wound.
Proper use and maintenance of wound drainage equipment are essential for effective wound healing and for preventing complications.
Here are some of the general guidelines for its use and maintenance:
Carefully follow the instructions given to you by your doctor
Hand hygiene: Before handling wound drainage equipment, thoroughly wash your hands with soap and water or use an alcohol-based hand sanitizer. This helps reduce the risk of introducing infection into the wound.
Bandage changes: If you have bandages in place along with the drainage equipment, follow the instructions given to you by your healthcare provider for changing the dressings. This may involve cleaning the wound, applying new dressings, and securing drainage tubes or devices in the appropriate position.
Empty or replace collection devices: If you have a drainage collection device, follow the instructions on when and how to empty or replace it. You will typically be advised to empty the collection device when it is about half full. Be sure to dispose of the drained fluid according to the provided instructions.
Drainage tubes: Ensure that drainage tubes are properly secured to prevent accidental movement. Your healthcare provider may have given you adhesive strips or other methods for securing them. If you notice that the tubes have become loose, contact your doctor for guidance.
Monitor drainage output: Monitor the quantity and characteristics of the drainage output as directed by your doctor. This may involve measuring the output using a measuring cup or keeping a record in a diary. Inform your doctor if you notice any sudden changes in the quantity, color, or consistency of the drainage.
Clean and maintain the equipment: If you have reusable equipment such as drainage collection bottles, clean them according to the instructions provided by your healthcare provider. This typically involves washing them with mild soap and warm water, thorough rinsing, and allowing them to fully dry before reuse. Adhere to the cleaning and maintenance guidelines to ensure proper hygiene.
Who performs this type of procedure?
The wound drainage procedure is typically performed by healthcare professionals who have appropriate training and qualifications. The specific healthcare provider performing the procedure may vary depending on the setting and complexity of the wound. Surgeons, nurses, and technicians commonly perform drainage procedures.
Common complications:
Infection
Although wound drainage aims to prevent infection, there is still a risk of infection. It is important to monitor the wound for signs of infection, such as increased redness, swelling, warmth, or the presence of pus. Notify your doctor immediately if you suspect an infection.
Pain and discomfort
The presence of drainage tubes, bandages or adhesives can sometimes cause skin irritation or allergic reactions. Tell your doctor if you have skin problems.
Skin irritation
The presence of drainage tubes, bandages or adhesives can sometimes cause skin irritation or allergic reactions. Tell your doctor if you have skin problems.
When is it necessary to seek medical help?
After wound drainage, it is important for patients to monitor their condition and contact their doctor if they experience any of the following situations:
Increased pain
If you experience a significant increase in pain that is not relieved by prescribed pain medication or other recommended measures, it is important to contact your doctor. This could be a sign of infection, or a complication related to the drainage.
Excessive bleeding
If you notice profuse or uncontrolled bleeding from the wound site, it is important to seek medical help immediately. Applying gentle pressure with a clean cloth or dressing can help control minor bleeding, but persistent or heavy bleeding should be addressed by a healthcare professional.
Signs of infection
If you notice any signs of infection, such as increased redness, warmth, swelling, the presence of pus, or a foul odor from the wound site, it is crucial to contact your doctor. Infection can interfere with the healing process and may require further medical intervention.
Worsening symptoms
If your symptoms worsen or if you develop new symptoms such as fever, chills, or a general feeling of unwellness, it is important to inform your doctor. These symptoms may indicate an infection or other complications that require medical attention.
Malfunction or displacement of equipment
If the drainage equipment, such as tubes or collection devices, becomes malfunctioning, detached, or damaged in any way, it is important to contact your doctor.
