Closed Suction Drain: Pilonidal Surgery Post-Op Instructions

Caring for your surgical drain

You have a drain from surgery since fluid will accumulate under the potential space under the surgical flap. If you have a drain with a tube connected to a bulb, then you have a “closed suction drain.” Here’s how to take care of it:

Secure the tube and bag inside your clothing with a safety pin. It may be uncomfortable for you to sleep on your back for the 8 days the drain is in.

  1. Empty your drain at least twice a day into the provided measuring cup and record the volume of fluid to show Dr. Sternberg at your next appointment.
  2. Change the dressing around the tube every day.
  3. You should remove the dressing when showering and replace it.
  4. “Stripping” the tube helps keep blood clots from blocking the tube. Best to do with an alcohol swab or with soapy fingers (so your fingers slide).
  5. Please wash your hands thoroughly (goes for a helper if you have one too) before emptying the drain!
  6. The bulb should be partially compressed at all times. If the bulb is full and round, then it is not applying suction, and should be re-compressed.

Emptying the bulb:

  1. Get your measuring cup ready.
  2. Clean your hands well with soap and water or with an alcohol-based cleanser.
  3. Open the bulb cap.
  4. Empty the fluid into the measuring cup and record the date and the time for Dr. Sternberg.
  5. Squeeze the suction bulb and hold it flat.
  6. While the bulb is squeezed flat, close the cap.
  7. Flush the fluid down the toilet.

If you need another Closed Suction Drain Output Record (the surgery center will provide you with one), download a PDF with the link provided.

What if there is no fluid draining into the bulb?

This may mean that there is no more fluid accumulating under the flap, but it could also mean that the drain is clogged. You should strip the drain.

  1. If you see a blood clot or obstruction in the drain, squeeze the tubing there to help break it up.
  2. Grip the drain with your fingers, close to where it exits your body and compress the tube to occlude it. With your other hand squeeze down the length of the tube with an alcohol pad or with soapy fingers (so they slide). Start where it comes out of your body and move toward the drainage bulb. Keep the stripping fingers compressing the tube and release the fingers compressing the tube where it exits your body. Do this several times until fluid is draining into the bulb.

What do I do if my drain appears to have clogged?

If you stripped the drain several times and there is no fluid draining into the bulb, your drain may be clogged. If you notice this the first night after surgery or the morning following surgery, no need to worry because I will unclog your drain in the office on your first postop day appointment.

If this occurs after you have seen me in the office, we will have sent you home with a 5-cc syringe. After washing your hands, please take the tube off of the drain bulb (just pull firmly). Draw 5 cc of air into the syringe and mate it with the end of the drain tube. Inject the air through the drain tube and then pull back on the syringe plunger to see if fluid comes into the tubing. If no fluid comes in take the syringe off and draw 5 cc more of air and inject that into the drain tube again. Then reattach the bulb and squeeze it by taking the white cap of it and squeezing the bulb.

Removing the Closed Suction Drain

The drain is removed after it puts out less than 20 cc of fluid each day for 2 days in a row. This is generally 8 to 10 days after surgery. Please call Dr. Sternberg before doing so.

Removing the drain is simple. Simply cut the suture holding it to the skin at the skin level and gently pull the drain out. The drain is approximately 15 cm or 7 inches long. It should slide out easily and not hurt. Before removing the drain, please call Dr. Sternberg. You should also gently remove the Steri-Strips by peeling them off without pulling aggressively after the drain is removed.

Once the drain is out, we want the hole inthe skin that the drain came out of to scab over. Please allow 3 or 4 days until it stops leaking. Then the patient can start to exercise with the caveat that they should not ride a bike, fall on their backside, or submerge in water. Squats are also not a great idea but lifting weights and walking or running is fine. Please have the patient call Dr. Sternberg a month after drain removal so I know they are okay.

Meet Your Surgeon, Dr. Jeffrey Sternberg

After many years performing major abdominal operations including open and laparoscopic resections for colon cancer, rectal cancer, Crohn’s disease, and Ulcerative colitis, I have chosen to concentrate my efforts in a few highly specialized areas of surgery where I feel I can make the greatest positive impact on patients.

More on my Training and Experience