Surgical drain is an instrument used in draining out excess blood, tissue fluids, pus or air from a surgical site inside the body in to outside following a surgical procedure. With the advent of advance imagery and the possibility to diagnose fluid collections using simple investigative means, use of drains have become a subject for debate but the counter arguments for its continuous use are still strong as well as supported by many. In certain situations, use of a drain is the norm and the main reason cited in its use is to prevent collection of fluids which can lead to poor wound healing as well as infections.
When discussing about the types of surgical drains, it can be classified into several groups and each group will pose its own surgical use.
Open drains:
Open drains do not posses a collecting system or an enclosed network but will drain the fluids that are getting accumulated within into a pack of gauze or into a stoma bag. Most often the drain would be a corrugated rubber or a plastic sheet. The drain will be opening into the outside through a wound in the skin as with any other surgical drain.
These drains are less likely to be kept for long durations and do not possess the ability to measure the amount that is drained. Due to the fact that it can easily lead to infections, open drains are used in surgical procedures which usually are devoid of contaminated or infective material.
Closed drains:
These drains are closed systems and can be considered as sealed in its exposure to the outside. Usually a draining tube will be connected to a bottle or a bag which will allow the nursing staff to measure the amount which was drained.
The system is used in surgeries related to chest, lungs and abdomen and has the potential to be kept even several days or weeks till the accumulation of fluids are minimal as the risk of infection is minimal.
Passive drains:
Some of the drains which are being used will be kept passive in its suction potential and this will allow the collecting fluid to drain according to the natural pressure difference between the inside and outside or based on the gravitational effect. Due to its passive nature, these drains would not be exerting any pressure on the healing wound.
Active drains:
These systems are maintained in positive or negative pressure and the amount of pressure can sometimes be adjusted according to the clinical judgment.
Most often the draining tubes are made from inert material such as silastic rubber and thus will give rise to minimal tissue reactions. But, at times, it may be helpful to have a long lasting natural draining canal by the use of an artificial drain and the red rubber tubing seems to fulfill this need following an intense tissue reaction.
As explained, these drains can come in different forms and sizes with various techniques in its operation. Therefore, it is the surgeon who will make the ultimate decision to choose an appropriate drain or else to decide its absolute necessity in the first place.
