This educational writing covers how to care for your drains. It also reviews what you can expect and what underwear and clothing is best after your tummy tuck or abdominoplasty procedure. It is important to be educated after an abdominoplasty, and understanding the drains and their care is important. Please also see my additional instructions for tummy tuck recovery under patient forms in the menu of my web page found here.
Abdominoplasty surgery can make fabulous improvement to the stomach area making it flatter, thinner, and more sculpted. Recovery does take time however, and patients need to be ready and educated for this phase of the operation. Drainage tubes are necessary to collect fluid after the operation. The great majority of doctors use drainage tubes, because they believe it gives better results with lower risks. Some doctors don’t use them, but I believe this is not wise. I also believe you will not get as flat a stomach if they are not used. I believe they are a critical part of the healing process. They also will lead to the flattest stomach and the best results.
The drains are plastic “balls” that work by suction. They are classically called Jackson-Pratt drains. This is a brand. The drain or “ball” is connected to a tube that is placed at the time of surgery. At the end of the tube is a lot of holes that suck up fluid. The fluid is called serous fluid. This is bloody tinged fluid. The fluid will sometimes have blood clots in them. This is ok. It is not the blood clots that form in the legs that is of serious concern. The drain ball should be squeezed flat. This creates the suction to suck out the fluid. It doesn’t work if it is not squeezed.
Tummy tuck drain care is very easy. Clean your hands before and after touching them. Hands have bacteria on them, and hand washing decreases bacteria and the chance of infection. Also, don’t touch the tube where the tube goes in the skin. This can increase your chance of causing infection or a problem. Use a Q-tip or gloved hand to apply Neosporin, Bacitracin, or Triple Antibiotic ointment once or twice a day to where the tube enters the skin. After the ointment is applied, cover the first part of the tube with gauze or panty liners. It doesn’t have to be sterile, but clean gauze or panty liners is fine. Daily showers is also recommended as this keeps the area clean and minimizes infection.
Empty and record drainage amount from the drain twice a day. The first few days after surgery you might have to empty it more frequently. Empty them extra times if the ball gets too full. This will minimize the chance of spillage or making a mess. There are numbers on the side of the drainage ball. These numbers are ml’s or cc’s. These are equivalent and are used for the measurements. Do the measuring when the ball is open or not squeezed. You should write down these numbers. The fluid can then get discarded in the sink or toilet. The amount of fluid draining will determine when the tubes are removed. Expect the number to gradually decrease. Sometimes it will drain less and other days more. It is common for this to go up and down. The trend tends to be less with time. The first several days you might have to empty it more than twice a day.
As mentioned above, it is common for small blood clots to get in the tubes. These are not the blood clots known as Deep Venous Clots. These small clots in the tube have nothing to do with those clots. These are just part of the healing after the tummy tuck. However, the small clots can clog up the drains. This might require “milking” or “stripping” the tube. This means you slowly push the clot along the tube, so the clot gradually goes in the ball. The nurse will show you how it is done. It sounds scary, but is very easy. The tube is pinched with one hand to hold it steady. With the second hand, two fingers are used to gently pinch and slowly advance the blood clot forward. Do it several times. This will gradually lead to clearing of the tube.
I recommend wearing underwear over the drain and groin area. Certain styles are best. Thongs or no underwear is not recommended. Wear older styles like “granny” panties. These are also called “full coverage cottons.” The fabrics and color do not matter. Make sure the drain comes down where the leg comes out. Don’t have it come out over the top. After the underwear is on, I recommend you use a cotton T-shirt. This must be long enough to cover the groin area. It should not stop short at the pubic hair line. We want it to completely cover the entire area. It provides extra soft padding for the incision and the healing process. Finally, the abdominal binder is placed. The drains are fastened to the binder.
Drainage tubes stay in about 7-10 days. It is very common to have drainage around the tube. This means the fluid can run down your leg. This can be concerning or worrisome, but it is normal and to be expected. The drainage tubes collect most of the fluid, but not all of it. The gauze or panty liners will collect the extra fluid. If this happens too much, look to see if a clot is blocking the tube. This can be milked forward as described above to help the tubes work. Each visit to the office will allow my nurses and me to check your healing and drainage tubes. They may sound scary, but most people find they are not really all that bad. I believe they are extremely important. I also find they can help us get the extra flat stomach we want after an abdominoplasty or tummy tuck!
I practice exclusively cosmetic surgery. Please call with any questions. Education about your operational leads to better results and satisfaction.