Drain tubes are an unfortunate part of the business of breast reconstruction and augmentation, especially if you are using tissue expanders to have your chest rebuilt. Because you have foreign objects inserted into your chest, your body may try to reject them. That can lead to a buildup of lymphatic fluid and infection. The drain tubes minimize the amount of fluid buildup, reduce the chance of infection, and make it easier to heal, but you should know what to expect and how to care for them.
What are drain tubes?
The drain tubes are essentially long plastic tubes with a squeezable, clear bulb at the end. The tubes are used after many different surgeries, but when used during breast reconstruction, they'll be placed under your skin and near the tissue expanders.
A few light stitches will hold the tubes in place, but as they fill with fluid, they can become heavy and uncomfortable. The feeling of the tubes under your skin may also be uncomfortable, but they aren't outright painful on their own. Expect anywhere from two to four tubes, depending on your doctor's preferred method.
How do they work?
The lymphatic fluid gets sucked into the tube through "negative pressure." You squeeze the bulb tight when it is empty and insert the plug at the top. Gradually, the fluid works its way down the tub, expanding the bulb until it is ready to be emptied.
Lymphatic fluid is generally clear or white on its own, but the fluid you see may be dark and bloody looking because of a mixture of red blood cells from the surgical site leaking into the tube as well. That's fine. The fluid in one tube may not even be the same color as the fluid in another tube, depending on the ratio of lymphatic fluid to blood in each tube. There's no reason to panic.
What should you bring home with them?
If the hospital or doctor doesn't automatically offer the following items, ask for them:
Measuring cups with the CC units or milliliters marked on the side so that you can track the amount of fluid each tube produces.
Alcohol wipes so that you can wipe the opening of the bulb and its cap each time you empty the bulbs.
Extra padding or gauze and paper tape to place around the tubes where they enter your body. You'll want to change them after each shower or if they become saturated with fluid.
A belly band that is designed to help hold the tubes around your stomach area, keeping them from getting accidentally pulled on.
How do you clean them?
You should empty them as often as your doctor recommends, but at least every 24 hours. You will need to keep a record of the amount of fluid that each bulb accumulates in order to show the doctor at your next office visit. When the fluid slows down enough, the doctor will be able to remove the tubes.
To clean them, you need to take certain specific steps:
Wash your hands with an antibacterial soap.
Milk the tube by gently and gradually pulling the fluid through the tube into the bulb. This helps keep the tube open and flowing and gives you a more accurate fluid count.
Open the cap of each bulb one at a time, and squeeze the contents into the measuring cup. Note the date, the time, and the amount of fluid on a sheet of paper so that you can take it to the doctor.
Flush the fluid down the toilet. Lymphatic fluid can be thick, and you don't want it to sit around the drain of your sink.
Wipe the cap with the alcohol wipes and squeeze the air out of the bulb tightly with your fist, then recap it.
Check the dressing around the entrance of the tube into your body to see if it needs to be replaced and replace it if it isn't looking clean or feels damp.
What happens if a tube falls out?
Tubes do occasionally fall out. Sometimes the sutures just loosen up too much, and the tube slips out on its own. Sometimes a small child or anxious pet might catch the bulb with a hand or paw and cause it to pull out. If you aren't in any pain and there isn't blood or fluid gushing from the site, call your doctor's office and let him or her know what happened. Your doctor will decide what to do from there.
If there's any significant pain or a lot of fluid comes rushing out, go to the hospital and let the hospital assess you and call your doctor for you. That way you aren't taking any unnecessary risks with damage to your skin or to the surgical site.
For more information, contact Merrick Plastic Surgery SC or a similar location.