Understand · Surgery
The short answer on caring for a surgical drain
A surgical drain is a thin tube that carries fluid away from your incision into a soft bulb. At home, your job is simple: empty the bulb, squeeze it flat so it keeps pulling, write down how much came out, and keep an eye on the spot where the tube leaves your skin. It usually comes out in an office visit within one to two weeks, once the fluid slows down.
What to know about caring for a surgical drain
- Your team's sheet wins. Hospitals give slightly different instructions. If anything here differs from yours, follow yours.
- Flat bulb, closed plug. The drain only works when the bulb is squeezed flat with the plug in.
- Write it down. The amount you record each day is how your team decides when the drain can come out.
- The fluid changes. It usually starts dark red, turns pink, then pale yellow and watery.
- Know when to call. Fever, spreading redness, cloudy or smelly fluid, or bright red bleeding are worth a call.
What is a surgical drain after breast surgery?
Most breast surgery drains are a type called Jackson-Pratt, or JP. (Some hospitals use a similar one called a Blake drain.) One end is a soft, flat tube with small holes that sits under your skin near the surgery. It comes out through a small opening, usually near the armpit, and a stitch holds it in place. The other end is a clear, lemon-shaped bulb with a plug.
When the bulb is squeezed flat and plugged, it gently pulls fluid out of the space where tissue was removed. That fluid would otherwise collect under the skin and slow healing. Some people have one drain, some have two or more.
What supplies do you need to care for a surgical drain?
- A measuring cup marked in milliliters (mL). Your hospital usually gives you one.
- A notebook or the log sheet from your hospital, and a pen
- A safety pin, lanyard, drain belt or camisole with pockets
- Soap and water, or hand sanitizer
- A mirror, so you can see what your hands are doing
- Gauze and tape, if your team tells you to cover the site
Our surgery recovery checklist has more of the small things people say helped.
How do you empty a surgical drain?
How often depends on your hospital and how much fluid is coming out. Instructions range from twice a day to every few hours in the first days. Many say to empty it whenever the bulb is about half full.
- Wash your hands. Soap and water for 20 seconds, or hand sanitizer.
- Unpin the bulb, and hold it so the tube doesn't tug on your skin.
- Open the plug. The bulb will puff up. Try not to touch the inside of the plug or the opening.
- Pour it out. Turn the bulb upside down and gently squeeze the fluid into the measuring cup.
- Squeeze it flat. Squeeze the empty bulb until your fingers almost meet.
- Close the plug while it's still flat. This is the step that makes the suction work.
- Pin it back on, below where the tube comes out, so it doesn't hang or pull.
- Check and write down the amount and the color.
- Flush the fluid down the toilet, rinse the cup and wash your hands again.
If you have more than one drain, measure and write down each one separately.
How do you keep a drain log?
Write down the date, the time, the amount in mL and the color, every time you empty it. Bring the log to your follow-up visits. A simple table is enough:
| Date | Time | Drain 1 (mL) | Drain 2 (mL) | Color |
|---|---|---|---|---|
| Mon | 8 am | |||
| Mon | 8 pm | |||
What should drain fluid look like?
In the first day or two, the fluid is usually dark red. Over the following days it turns pink, then pale yellow and watery, and the amount should slowly go down. Small air bubbles and little stringy bits are normal.
Tell your team if the fluid turns dark or bright red again after it had lightened, or if it looks cloudy, milky, green or thick, or smells bad.
What should you do if a drain seems blocked?
Small clots can block the tube. Signs include fluid leaking around the spot where the tube comes out, a bulb that won't stay flat, or fluid that suddenly stops. Freeing it is called "milking" or "stripping" the tube. Some teams also ask you to do it before every emptying.
- Wash your hands. A drop of lotion or an alcohol wipe on your fingers helps them slide.
- With one hand, pinch the tube close to your skin and hold it still, so you don't pull on the stitch.
- With the other hand, pinch just below and slide your fingers down the tube toward the bulb.
- Repeat a few times until the clot moves into the bulb.
If two or three tries don't clear it and fluid still isn't moving, call your team.
How do you care for the skin where a drain comes out?
Look at it once a day, using a mirror if you need to. A little redness right around the opening is normal. Memorial Sloan Kettering describes it as about the size of a dime. Keep the area clean and dry, and cover it with gauze only if your team tells you to.
How do you shower and get dressed with a drain?
Showers: wait until your team says it's OK. Some hospitals allow it a day or two after surgery, and others want you to wait. When you do shower, hang the drain from a lanyard or a belt, don't aim the water straight at the opening, and pat the area dry afterward. No baths, pools or hot tubs while the drain is in.
Clothes: tops that button or zip up the front are easiest. Pin the bulb to your top, a lanyard or a drain belt rather than your pants, and keep it below where the tube comes out. A pocket helps. One hospital suggests wearing a hoodie inside out, so the front pocket is on the inside and the bulb is out of sight.
What should you do if something goes wrong with a drain?
The bulb won't stay flat. Make sure the plug is pushed in all the way, then empty and squeeze it again. Some people put tape over the plug. If it still puffs up, call your team. It isn't an emergency, but the drain isn't working.
The tube slides partway out. Don't push it back in. Call your team.
The tube falls out completely. Cover the opening with clean gauze and call your team. A little fluid may keep leaking for a while.
When and how does a surgical drain come out?
Your surgeon or nurse decides when the drain can come out, mostly based on your log. A common rule is when less than about 25 to 30 mL comes out in 24 hours, which is often one to two weeks after surgery.
It's done during a regular office visit. They clean the area, cut the stitch and slide the tube out. Most people feel a strange pulling for a few seconds. Breathing out slowly can help.
Afterward you'll have a small gauze bandage. Many teams say to leave it on for about a day, and the opening usually closes in a few days. Sometimes fluid builds up under the skin after the drain is out. It feels like a soft, squishy swelling and is called a seroma. It isn't an emergency, but tell your team, since it sometimes needs to be drained.
When to call your care team about a surgical drain
- A fever. Hospitals use different cutoffs, often 100.4°F (38°C) or 101°F (38.3°C). Use the number your team gave you.
- Bright red fluid or bleeding that doesn't stop
- Redness that spreads, red streaks, swelling, warmth or pus around the opening
- Fluid that's cloudy, milky, green, thick or smells bad
- Fluid that suddenly stops, drops sharply or jumps up
- A clot you can't move, a bulb that won't stay flat, or a drain that falls out
- Fluid leaking around the tube or from the incision
Get the after-hours number before you leave the hospital. If it feels like an emergency, call 911.
Questions to ask about your drain before you go home
- How often should I empty my drain, and should I milk the tube every time?
- What amount should I call you about, either too much or too little?
- What temperature counts as a fever for me?
- When can I shower, and do I need to cover the site?
- Should I keep a dressing on the opening, and how do I change it?
- Around how much fluid do you want to see before it comes out?
- Who do I call at night or on the weekend?
Want the bigger picture? Read what actually happens during a mastectomy, and after.
From the Toolkit
- The Surgery Recovery Checklist Interactive checklist
- Questions for your surgeon Printable
- Everything for surgery in The Toolkit Toolkit
Sources: Memorial Sloan Kettering Cancer Center, Caring for Your Jackson-Pratt Drain (updated July 2023). Cleveland Clinic, Jackson-Pratt (JP) Drain (reviewed October 2023). MyHealth Alberta, Breast Cancer Surgery: Drain Care (2022). This article is general information, written in Babette's own words, and is not a substitute for your care team's instructions. Illustrations by Babette.
