Surveillance and maintenance of a drainage system featuring a wound.
Objective:
To maintain patency of a drainage system by preventing complications such as infections, displacement or pullout, and suture dehiscence.
Equipment:
– Dressing trolley or trough. – Sterile drapes. – Support for the drainage bag. – Dressing equipment: forceps with teeth, without teeth, sterile scissors, mosquito, scalpel handle, kocher forceps and needle holder.
Material:
– Sterile gloves. – Non-sterile gloves. – Sterile gauze. – Drainage bag. – Alcoholic hand disinfection solution. – Scalpel blade. – Sterile drainage system. – Soaker. – Bag for waste. – Anti-allergenic plaster. – Antiseptic solution. – Physiological saline solution. – Sterile dressings. – Bandages. – Nursing records.
Procedure:
– Perform hand washing. – Prepare the material and move it to the patient’s room. – Preserve the patient’s privacy. – Inform the patient of the procedure. – Ask the patient and family to cooperate. – Place the patient in a suitable position to have access to the area to be treated. – Put on non-sterile gloves. – Place the dressing under the area to be treated. – Remove the dressing in the direction of the hair, wetting the dressing with saline if it is very adherent. – Drainage assessment: permeability, volume, color and odor of exudate. – Inspect sutures and condition of the incision. – Empty the drainage system. In the net type devices, clamp the tube, disconnect the container and measure in the graduated cup. Place a new collection container to which the vacuum has been made and unpin. – Remove gloves. – Proceed to alcohol disinfection of hands. – Prepare a sterile field and place on it all the necessary material for the treatment. – Put on sterile gloves. – Clean the wound with physiological saline solution by dragging it from the center of the wound to the ends, from the cleanest to the least clean area. – Dry with sterile gauze. – Apply antiseptic. – Cut with sterile scissors the gauze from the middle of its edges to the center and place it around the exit of the drainage tube, fixing it to the skin (closed drains). – In Penrose type drains the wound will be covered with gauze sufficient to absorb the exudate. If it is excessive, place collection bags. – Cover the drain with a sterile dressing separate from the surgical wound dressing. – Number the collection devices if there is more than one. – Tape the drain to the patient’s clothes or bed.
If the drain is to be removed:
1. Clean the surgical wound first and cover it with sterile gauze. 2. Using a forceps mounted with gauze, clean the drainage area with saline solution in circles from inside to outside with antiseptic solution. 3. With scissors cut the skin fixation point. 4. Remove the drain gently, but quickly and continuously. 5. Cover the hole with sterile dressing.
– Collect the material. – Leave the patient in a suitable position. – Remove gloves. – Perform hand washing. – Record in nursing documentation: procedure, exudate characteristics, date and time and patient response.
Observations:
– Maximum asepsis. – Wash hands with antiseptic. – Change dressing every 24 hours or when soiled or wet. – Notify the physician if signs of infection are observed.
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