Plastic surgeons use drains in many procedures to help reduce the risk of seromas. Seromas are collections of normal serous fluid that the body pushes out into the surgical dissection area. Seromas can increase the risk of postoperative infection, prolonged inflammation, or thickening and hardening of the skin after surgery.
Surgical drains are often long plastic tubes with a plastic bulb on the end, like Jackson-Pratt (JP) or Blake drains. These drains are known to be difficult for patients to manage and can cause stress for them and their families. For this reason, Dr. Keelee MacPhee stopped using these drains years ago and found that the Penrose drains were a much more comfortable substitute.
Penrose drains are made of soft, flexible rubber and are sutured in place with nylons. They direct the normal drainage into one area on each side of the chest after top surgery. This allows for easier postop care since all the normal drainage is located over the drains. The patient simply changes their gauze pads over that area when they are wet.
The drainage in that area means the longer incisions will seal up more quickly and there will not be drainage across the whole chest. The patient does not have to monitor the output of these drains for quantitative purposes.
Penrose drains are typically removed about a week after top surgery. They are easily removed and glide out without any pain; the patient usually does not feel the drain being removed after the little stitches are snipped.
Without the drains, there will be more drainage across the long incisions, which will take longer to seal well. The body must absorb all the serous fluid or develop a seroma. A larger inflammatory reaction to the undrained serous fluid across the chest will occur.
Drainless surgery can be performed but will take longer in the operating room. This adds more possible suture reaction and pain from more sutures in the muscle fascial layer.
The Penrose drains hasten recovery benefits and outweigh the alternatives.
