Dr. Mohammed Ghalwash - Dr. Khaled Ghalwash

Surgical excellence through meticulous care and attention to detail

Please watch this brief video on how to correctly strip, empty, and care for your Jackson-Pratt Drain:

Instructions for Stripping and Emptying The Drain:

Please be sure to fill out the drain record sheet after surgery. This will determine when your drains are ready to be removed.

STRIP the drains every 2 hours

It is important to strip or "milk" the drainage tube in the direction going from the skin exit site toward the bulb. This is done by pinching the drainage tube with both hands and fingers close together, then sliding one hand down the compressed tube toward the bulb, then releasing. Dr. Romano calls this "pinch, strip, release".
You will need to do this every two hours with about 3-4 repetitions.

EMPTY the drains TWICE a day or approximately 12 hours apart or when they are half full

Remove the stopper from the bulb's spout or drainage port. This will release the vacuum and the bulb will expand. Take note of the amount of drainage in the bulb by reading the numbers on the bulb.
Record the amount on the chart. If the drain fills up a lot, empty it more than two times a day. Then, discard any fluid. Flatten/squeeze the bulb to create a vacuum and plug the stopper back into the drainage hole. The drain should appear somewhat flat. If the drain is not flat, the suction is not working.

This is what a Jackson-Pratt drain should look like if it's working properly. This is prior to the stopper being opened and the drain being emptied.

Remember to bring your output record with you to your post-operative appointments. The amount of drainage recorded below will determine when the drain will be removed.

New Patient Information

Record drain output here:

Date	Morning Amount (ml)	Evening Amount (ml)	Total

Types of Surgical Drains

Understanding Surgical Drains in Aesthetic and Reconstructive Surgery

Surgical drains are essential tools used in many plastic surgery procedures to remove excess fluid that may accumulate at the surgical site. Dr. Khaled Ghalwash and Dr. Mohammed Ghalwash carefully evaluate each case to determine whether a drain is necessary for optimal healing.

Suction vs. Non-Suction Drains

Our practice utilizes two main types of drainage systems, each serving specific purposes:

Suction Drains (Jackson-Pratt/Radivac): These create active suction to efficiently remove fluid from deep surgical sites. They're commonly used in procedures like abdominoplasty, breast reconstruction, and extensive body contouring where significant fluid accumulation is expected.
Non-Suction Drains: These rely on gravity and capillary action to drain fluid. They're typically used in less extensive procedures or areas where gentle drainage is preferred.

When Drains Are Necessary

Not all aesthetic or reconstructive procedures require drains. The decision to place a drain depends on several factors including:

The extent of tissue dissection
Expected amount of post-surgical bleeding or fluid collection
Location of the surgical site
Individual patient factors

Proper drain care is vital for preventing complications like infection, delayed healing, or seroma formation. Following your drain care instructions diligently will help ensure optimal healing and recovery.

Caring for Your Surgical Site

Proper Care Around Drain Sites

In addition to emptying and recording drain output, proper care of the area surrounding your drain is essential for preventing complications:

Keep the area clean: Gently clean the skin around the drain insertion site with mild soap and water once daily, unless instructed otherwise.
Observe for signs of infection: Redness, increasing tenderness, warmth, or purulent (cloudy/pus-like) drainage may indicate infection and should be reported promptly.
Secure the drain: Use the provided safety pin or clip to secure the drain to your clothing, reducing pull on the insertion site.
Avoid showering directly over drains: Follow your surgeon's specific instructions regarding showering with drains in place.

When to Call Your Surgeon

Contact our office immediately if you experience any of the following:

Sudden increase in bright red blood in the drain
Drain becomes dislodged or falls out
Drain clogs and stops collecting fluid despite proper stripping
Signs of infection (increased redness, warmth, pain, or discharge at drain site)
Fever over 101°F (38.3°C)
Bulb cannot maintain suction despite proper emptying technique

Drain Removal

Drains are typically removed when the output decreases to an acceptable level (usually less than 30ml per 24 hours for 2 consecutive days). This process varies by individual and procedure, but most drains remain in place for 7-14 days.

Drain removal is a quick procedure performed in our office. While you may feel a brief, pulling sensation, most patients find the process less uncomfortable than anticipated. After removal, a small dressing will be placed over the site, which can typically be removed after 48 hours.