Introduction A JP Drain is a soft tube and container used to drain fluids that build up under the skin after surgery.
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1 JP Drain Introduction A JP Drain is a soft tube and container used to drain fluids that build up under the skin after surgery. This reference summary explains what a JP Drain is and discusses how to take care of it. Drainage After an operation, normal oozing of blood may occur in the surgical area. Other fluids can also build up in the surgical area in reaction to JP Drain an operation. One of these fluids is known as serous fluid, which is a byproduct of blood. A clear or yellow colored fluid can sometimes accumulate in the surgical area. When these fluids are combined, they are generally known as serosanguineous fluid. Typically the tissues reabsorb this drainage over time. Rarely, the accumulation of these fluids can stretch the incision causing it to open. Such a problem is known as wound dehiscence. The fluid collecting under the skin can also become infected, which can cause serious complications. Draining this excess fluid to the outside of the body helps decrease the chances of wound dehiscence and infections What Is a JP Drain? At the time of surgery, the physician uses a special tube to drain the fluid that builds up in a surgical site under the skin. The tube is placed in your wound and taken to the 1
2 outside through a small opening in the skin near the suture line or incision. The tube is connected to a suction device known as a bulb. The tube and the bulb are known as Jackson-Pratt drain or JP drain for short. The bulb can be squeezed to create a vacuum that will make a suction effect. The drain system operates only if the tubing is not obstructed and there is suction. As the drainage fills the bulb, the suction gets weaker and slows down the flow of drainage from your body. That is why the drainage should be emptied from the container when it becomes half full. This helps keep as much suction as possible in the JP drain. You should empty the drainage container 3 times a day or more frequently if the container becomes half full. JP Drain Milking the Tube When milking the tube, emptying the drain and/or changing the dressing, select an area that is clean and uncluttered. It needs to be large enough to work and have good lighting. Wash your work area. Wash your hands with soap (antibacterial liquid soap if possible) and water. Handwashing is the most basic way to prevent and control the spread of germs. Follow these instructions for handwashing: Wet hands and wrists under warm running water. Apply soap (antibacterial liquid soap if possible) and lather well. If you use a bar soap, keep it separate for your own use only. Rinse the soap before and after you use it to remove the lather. Scrub hands and wrists for at least 15 seconds. Pay special attention to fingers, fingernails and the backs of your hands. Rinse hands well with your hands up. This keeps the dirty water running away from your hands. It is best to dry your hands using clean paper towels starting with the hands and working down towards the elbows. Use a clean paper towel for each hand. 2
3 You may use cloth towels to dry your hands. Use a clean towel for each hand. Keep the towels separate and use clean towels daily. Use the paper or cloth towel to turn off the faucet. (Remember, you turned it on with dirty hands). You milk the tube to prevent any thick drainage from clogging the inside of the tube. It is a good idea to milk the tube before you empty the drainage or as directed by your health care provider. Wash your hands and unpin the JP drain from your clothing, close the safety pin to avoid pricking yourself, the tube or the JP drain. Start from the top of the tube closest to your body where it comes out from the dressing. Gently squeeze the tube with 2 fingers and keep compressed. With your other hand, use 2 fingers to gently squeeze the tube as you move your fingers down the tube toward the JP drain. Emptying the JP Drain Empty the JP drain when the bulb is half full. If it does not need to be emptied, pin it to your clothing. Be careful not to prick the tube or the JP drain. You will need a clean measuring container and alcohol prep pads. The disposable clean gloves are optional. Follow these instructions. Remove the cap from the measuring container. Open the alcohol prep pad by tearing down on one end of the package. Do not take the pad out until you are ready to use it. You may use a clean towel to protect your clothing from any spills. Open the cap from the drainage spout on the JP drain away from your face. Be aware that the JP drain will quickly expand into a ball shape when the cap is opened. Turn the drain upside down over the measuring container. 3
4 Gently squeeze the drain to help empty as much of the drainage as possible. Clean the cap and the spout of the JP drain using the alcohol prep pad. Squeeze the JP drain and roll towards the tube. Hold the rolled bulb as you replace the cap. This will restore the suction. If the suction is correctly restored, the bulb will look like the letter C. Pin the drain to your clothing where it will be most comfortable and to prevent any pull on the tubing. Check your drain often to be sure it is keeping the suction. Changing the Dressing You should change the dressing daily or as instructed by your physician. You will need the following supplies to change the dressing: A clean towel or protective pad for spills Antibacterial liquid soap and water Clean washcloth to wash the area Small towel or washcloth to dry the area Cotton topped applicator (optional) Tape Plastic trash bag Split gauze dressing JP Drain with restored suction You can use a cotton-tipped applicator or a gauze instead of a washcloth. Make sure they have not been used before. If the washcloth has been used before, it should be washed before using it again. Follow these steps to change the dressing: 1. Wash hands. 2. Place a protective pad under the drain site to catch any drainage or spills. 3. Tear the tape needed to secure the new gauze dressing and the tube to the skin. 4. Gently loosen the tape-held dressing around the tube. 5. Carefully remove the old dressing from around the tube. Put in a plastic trash bag. Wash hands or use hand sanitizer. 4
5 6. Check the skin around the tube for redness, soreness, swelling, drainage or odor. 7. Using a clean washcloth, carefully clean the area where the drainage tube enters the body using a circular motion. Start cleaning where the tube enters the body and move outward onto the skin. Discard the used washcloth. 8. Get a new or clean washcloth and discard the used one. Using the same circular motion used to clean the area, rinse the area with water using the new clean washcloth. 9. Pat the skin dry with a clean towel. 10. Open the split gauze dressing and place around the tube then tape it to the skin. Wash hands or use hand sanitizer. Empty the drainage from the container into the toilet and flush. Every time you empty the JP drain note the color, odor and amount of drainage. Record the amount of drainage in the drainage record log. Rinse the measuring container, and then wash it with warm soapy water. Finally, rinse it again and dry with paper towels. Remember to wash your hands after you finish milking the tube, emptying the drainage and/or change the dressing. Check the drainage in the tube to see if: The drainage is dark red, yellow or cloudy in color There is sudden absence or an increase of drainage flow in a 24 hour period You are unable to maintain suction in the JP drain As you empty the drainage from the JP drain, check the amount and color of the drainage. A pungent or strong odor from the drainage should be reported to your doctor. 5
6 Complications Check the drain site and report to your healthcare provider if you notice any of the following: You notice swelling or accumulation of fluid under the incision or around the suture line. There is leaking from the bulb, tube or on the dressing Report to your doctor if you have severe pain, which is not controlled by pain medication 1 hour after taking it. Also report if you have fever of 101 degrees Fahrenheit or higher. Summary After an operation, normal oozing of fluids may occur in the surgical area. Draining the excess fluid to the outside helps decrease the chances of infections and the opening of the incision. At the time of the operation, the doctor uses a special tube to drain the fluid that builds up in a surgical site. The tube is connected to a suction device known as bulb. The tube and the bulb suction are known as Jackson-Pratt drain or JP drain for short. Following good hygiene is important as you change the dressing around the tube and empty the drainage. It helps to prevent infection by keeping your skin and the tube clean. 6
7 DRAINAGE RECORD Date Time Amount 7
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