The JP drain is a soft, pliable bulb drain that is either tunneled directly into a surgical incision, or more often into another smaller "stab" incision right next to the main incision. The purpose of the JP drain is to allow the large surgical incision to heal well by draining blood and thin serous material that can build up behind fresh incisions.
The bulb part of the JP drain is connected to the surgical incision by means of a long plastic tube that’s sutured in place on the skin where it enters the body. When the bulb is compressed (squeezed together), it provides constant suction that draws any accumulating fluids such as blood, pus, or other thin drainage from the incision, through the tube and into the bulb. On a regular basis (at least once a day), the fluid that is collected in the bulb is emptied by opening the small plug in the top and squeezing the fluid into a measuring cup. While the empty drain is still unplugged, the drain is squeezed together to remove as much air as possible so it is mostly “flattened.” Then the plug is recapped. The flattened bulb gently expands as it again slowly suctions fluid from the incision.
Keep Track of the Amount of Fluid . . .
The amount of fluid, date and time, and any ususual details about the fluid (color, thickness, clots, smell) is written on a paper for the doctor to review at your appointment, then the drainage is emptied into the toilet and flushed away. Keeping track of the amount of fluid emptied from the bulb is important. This information allows the physician to know if the wound is healing according to schedule . . . or if there are complications that require further attention such as an unusual amount of blood coming from the wound, a foul smell to the discharge, or an unusually large volume of fluid. When the drainage falls to a certain level, usually a few days after surgery, the drain is easily removed by a physician or nurse at the doctor's office.
I’m by no means an artist, but I’m including a couple of my own sketches here. The websites (at bottom) often include great drawings or photos of the drains and their care, but of course they have copyrights to their art and photos so I’ll give you just a basic idea.
Parts of the JP Drain
Drain reservoir bulb—about the size and shape of a large lemon or (in my mind) a hand-grenade. Made of soft flexible semi-transparent silicone with an attached drainage tube that is sutured into a slit on the body near the surgical incision. In order to collect drainage from the tubing, the bulb plug must be opened, air is squeezed out until the bulb appears mostly flat. While still squeezing the bulb flat, the plug is replaced. As the bulb fills with fluid, it may expand. The bulb is emptied at least daily or when full and the drainage is measured and recorded and reported to the physician.
Drain aperture—the hole with a plug, this is where you empty the drainage that is collected. It reminds me of a beach-ball plug and works exactly the same way.
Drain tubing—hollow tubing made of a soft semi-transparent silicone. It’s connected to the drain reservoir bulb. Sometimes the tubing may accumulate drainage that becomes a clot which blocks the drainage. This can be cleared by a gentle pinching motion of the tubing just above the clot, away from the body and towards the bulb, it is usually recommended to “milk” the tubing in this way when needed to keep it draining freely.
Surgeries that result in a drain . . .
. . . includes just about any that may result in a large incision, for example, breast surgery, thyroid operations, weight loss surgery, abdominal surgeries, and operations on the kidneys or bladder. There are other types of surgical drains as well, but the JP is one of the most common.
Keep the JP Drain from Pulling on the Incision
To keep the weight of the drain from pulling on the incision, a flap of tape is applied near the bulb. A safety pin is pinned through this tape flap and then pinned to the patients clothing in such a way as to take up the slack of the tubing. (If you have more than one drain, they will each be numbered for easy reference on the tape flap.) Be careful not to poke a hole through the tubing of your drain!
I don't seek advertising or any funding for my blogging, but I do point out commercial products that may be helpful to my readers. Here are two products that I came across created by patients in order to more comfortably manage their JP drains post-operatively.
- Surgishorts is a unisex garment that has pockets specifically for the JP bulbs: http://www.surgishorts.com/.
- The drain pouch management gown is a unique hospital gown created with the post-op breast surgery patient in mind: Sage Solutions Drain Pouch Gown.
- National Institute of Health Patient Education: JP Drain (English) and in Spanish
- Breast Reconstructive Surgery.
- UCS Breast Center: JP Drains
- Jackson-Pratt Drain Care
- Health AtoZ: JP Drain pdf
- Carolina Breast Cancer Information
- Dr. Holmes MD Patient Resources
- Cheboygan Surgical
- UCS Drain Record Sheet