After Surgery: Understanding Jackson-Pratt Drains

Jackson-Pratt drains are a necessary component of breast reconstruction surgery. These post-surgical drains play a key role in preventing infection and facilitating effective healing. While they may be uncomfortable and at times even inconvenient, surgeons could not safely undertake major procedures without them. Read on for more information on what they are and how they work.

What are Jackson-Pratt drains?

Jackson-Pratt (JP) drains are surgical drains that help remove fluids from a surgical area. JP drains have multiple parts, including a thin, flexible tube that is placed under the skin, which attaches to a squeeze bulb. The bulb has a small, removable plug.

How do JP drains work?

JP drains use natural suction to draw fluid away from the surgical site. When you squeeze the bulb of the drain, it removes the air and generates suction that gradually pulls fluid into the bulb. As the bulb fills, that suction decreases. It is important to empty the drains regularly to remove fluid and reestablish suction. Patients empty the drain by opening the drain plug and squeezing out the contents of the bulb. Suction is then reestablished by squeezing the air out of the bulb again before replacing the plug.

Why are they necessary for recovery?

Whenever skin is opened, the body fills that area with fluids as part of a natural healing process. However, when we close the area, as surgeons do during a breast reconstruction, there is no way for those fluids to escape. The drains provide a controlled avenue for fluids to leave the body. Without drains, patients can develop something called a seroma, which is when fluid builds up in an area where tissue has been removed.

How long do drains typically remain in the body?

Most surgical drains stay in place for one to two weeks. However, that time frame varies heavily based upon patient and procedure type. Some procedures require more drains or longer drain use than others at the start. For example, natural tissue reconstruction procedures often require drains at both the breast reconstruction site and the donor site (the area from which the natural tissue reconstruction was drawn, like the abdomen in a DIEP flap).

Drain use duration ultimately comes down to drain output. It’s essential to log the output of each drain every time it is emptied. Then, your medical team can look at your drainage log and use that information to determine whether that drain needs to remain in place. The cutoff is usually 30ccs of fluid. If a drain produces less than that amount of liquid two days in a row, most physicians will remove the drain.

Surgical drains may be removed individually.

Different areas of the surgical site often heal at different rates. This is part of why it is so important to track drain output. In some cases, multiple or all drains are removed at once, but in others they come out one or two at a time. It truly depends on the fluid output of each drain.

Drains offer you and your team control.

Drains can be stressful to manage. If you are feeling frustrated, it can be helpful to remember that they offer you control over your recovery. They prevent fluid buildup and infection and offer a window into how each area of your reconstruction is healing.