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A mastectomy is a type of surgery to remove breast tissue in the treatment of breast cancer. Often, the patient will have a mastectomy drain temporarily placed in the area afterward. This drain, often called a Jackson-Pratt drain, is inserted through the skin to collect fluids resulting from the surgery. The tube connects to a bulb, which is attached to the clothing outside of the body. Before they leave the hospital, a nurse will teach patients how to take care of the drain.
Mastectomy drains will need to be emptied of fluids on a regular basis. Patients are shown how to drain the fluids and measure the amount. They must keep a record of the date and time, as well as the amount of fluids collected and the general color of the fluids. This helps the doctor know when to remove the mastectomy drain. Gradually, the fluid discharge from the wound should decrease. Patients should be aware that increasing their activity levels may increase the amount of fluid discharge.
The bulb attached to the tube should be checked often throughout the day, and patients should be able to see the level of fluid clearly. It ought to be emptied when it is half full, rather than completely full. For most patients, this generally means it requires emptying three times daily, including right before bedtime.
Before taking care of the mastectomy drain, the hands must be washed. The bulb should be grasped so that it is upright and its cap should be carefully removed. Patients may then turn the bulb upside down over a measuring container and squeeze it to drain all of the fluid. The bulb must be fully squeezed before the cap is replaced to allow for suction.
After recording the amount and color of the fluid and when it was emptied, the contents of the measuring cup may be emptied in a toilet. Patients should then rinse the container and wash their hands thoroughly. When the bulb is re-attached to the clothing, it should always be kept lower than the area of skin through which the tube is inserted.
The mastectomy drain is typically removed after one to two weeks, during the patient's follow-up appointment. Patients must observe the area carefully and report any abnormalities to their doctors as soon as possible. Indications of a problem include abrupt increase or decrease of drainage, foul-smelling fluid, or pus in the fluid or around the tube. The doctor will need to see the patient if the wound becomes excessively swollen, warm, or red, or if the patient develops a fever. Sometimes, the mastectomy drain falls out and requires re-insertion by the doctor, or fluid fails to drain properly and accumulates under the skin.