What is a disadvantage of a drain? Exploring the Risks and Complications

September 25, 2025 •

3 min read

According to a study published in the Journal of the American College of Surgeons, the odds of surgical site infections are significantly higher when drains are used in general surgery. This critical fact highlights a primary disadvantage of a drain: the increased risk of infection, as the device can act as a pathway for bacteria to enter the wound site.

Quick Summary

A primary disadvantage of a surgical drain is the increased risk of infection, as the device can serve as a conduit for bacteria to enter the wound site. Other significant drawbacks include pain and discomfort, skin irritation at the insertion site, and the potential for the drain to become blocked, dislodged, or leak, requiring careful management during recovery.

Key Points

Infection Risk: Drains provide a direct pathway for bacteria into the wound, increasing the risk of surgical site infection, especially with prolonged use.
Pain and Discomfort: The presence of the drain and accidental pulling or movement can cause significant pain, while the insertion site is prone to redness and irritation.
Technical Failure: Drains can become blocked by clots, lose suction, or be accidentally dislodged, compromising their function and leading to fluid buildup.
Aesthetic Concerns: The use of a drain can potentially delay wound healing and may result in a small but permanent scar at the removal site.
Patient Management Burden: Proper care, including regular emptying, measuring, and securing of the drain, adds responsibility and stress for the recovering patient.

The Primary Concern: Increased Risk of Infection

While drains are placed to remove excess fluid that can foster bacterial growth, their very presence can also be a source of contamination. The risk is elevated because the drain creates a direct pathway from the external environment into the healing wound. The risk of infection is influenced by several factors, including the duration the drain is in place, with prolonged drainage increasing the likelihood of surgical site infections (SSIs). Proper care, including meticulous hygiene, is essential to minimize this risk, but it cannot be eliminated entirely.

Factors Influencing Infection Risk

Drain Type: Open, passive drains, which allow fluid to seep into absorbent dressings, may carry a higher risk of retrograde bacterial contamination compared to closed suction systems.
Duration: A longer dwell time for any drain significantly increases the risk of infection. Studies suggest that for closed drains, removal within a certain timeframe, such as 6 days, may help lower infection incidence.
Patient Health: Factors such as smoking, nutrition, and existing medical conditions can weaken the body's defenses and make infection more likely.

Pain, Discomfort, and Skin Irritation

The presence of a foreign tube exiting the skin can cause significant discomfort and pain, which many patients find distressing during recovery. The pain is not limited to the drain's presence but is often exacerbated by movement or accidental pulling on the tube, especially when not properly secured. Furthermore, the insertion site is prone to irritation, leading to redness and itching that can be bothersome. This skin irritation, if not managed, can become a more serious issue.

Managing Pain and Irritation

Secure the drain properly to prevent accidental tugging.
Apply prescribed ointments or use gauze to cushion the insertion site and reduce friction.
Follow your healthcare provider's instructions for pain medication.

Potential for Technical Complications

Surgical drains are not infallible devices and are subject to several mechanical failures that can compromise their function and increase risks. These technical problems can lead to complications, including:

Blockage: The drain can become clogged with clots or other debris, preventing effective fluid removal. This can cause fluid accumulation, leading to increased pressure and pain in the wound area. Regular "milking" or "stripping" of the tube can help prevent blockages.
Dislodgement: The drain can accidentally fall out or migrate, which can happen with patient movement or if the fixation suture fails. If this occurs, it must be reported to the medical team immediately.
Leaks: Fluid may leak around the insertion site, causing skin excoriation and increasing the risk of infection. Ensuring proper suction (for closed drains) and secure placement can help mitigate this.

Impact on Wound Healing and Aesthetic Outcome

While drains are intended to promote healing by preventing fluid build-up, their effect is not always straightforward. The drain itself is a foreign object that can incite a local inflammatory response, potentially impacting the local tissue environment. Additionally, the presence of the drain can sometimes delay the normal progression of wound healing. After removal, a small scar may form at the insertion site. For some patients, particularly in plastic surgery, this aesthetic concern is a significant disadvantage.

Comparison of Drains: Weighing the Trade-offs


Feature	Advantages (Purpose)	Disadvantages (Potential Complications)
Infection Risk	Prevents fluid accumulation that supports bacteria	Creates a potential entry point for bacteria
Comfort	Can reduce pressure and pain from fluid build-up	Causes discomfort, pulling sensation, and skin irritation
Drainage Management	Provides visible monitoring of healing progress	Requires careful emptying, measurement, and securing
Wound Healing	Removes excess fluid to facilitate healing	Can cause local inflammation and potentially delay healing
Aesthetics	Can reduce hematoma formation and improve contour	May leave a small scar at the insertion site

Conclusion: Informed Decisions Are Key

Understanding what is a disadvantage of a drain allows for better patient preparedness and management. While drains are often necessary and beneficial, acknowledging their potential drawbacks—namely, the increased risk of infection, discomfort, and the possibility of technical failures—is crucial. Communication with your surgical team is vital to understanding the specific risks related to your procedure. Following care instructions diligently helps to mitigate these issues and ensure the best possible recovery. For more on surgical recovery, you can read the guidelines from the Cleveland Clinic on Surgical Drains.

Frequently Asked Questions

The biggest risk associated with a surgical drain is the increased chance of infection. By creating a direct channel from the outside environment into the wound, the drain provides a potential entry point for bacteria, which can lead to a surgical site infection.

Yes, surgical drains can definitely cause pain and discomfort. Patients often feel a tugging or pulling sensation from the tube, especially with movement, and the skin around the insertion site can become red, itchy, or tender.

If your drain gets clogged, it is important to address it promptly. First, try to "milk" or "strip" the tubing to move the clot or debris into the collection bulb. If this does not resolve the blockage, contact your healthcare provider for guidance, as a clogged drain can lead to fluid accumulation.

If a drain falls out, cover the site with a sterile dressing and contact your surgical team immediately. Do not attempt to reinsert it yourself. The medical team will assess whether a new drain is needed or if it can remain out, based on your recovery status.

While drains are meant to promote healing by removing excess fluid, their presence as a foreign object can sometimes incite a local inflammatory response that might impact or delay the healing process. It is a complex trade-off between managing fluid and the drain's potential influence on the wound bed.

Signs of a drain site infection include increased redness, swelling, or warmth around the insertion area, increased pain that isn't relieved by medication, a fever of 100.4°F or higher, or drainage that is smelly, green, or thick.

Yes, it is possible for a surgical drain to leave a small, temporary mark or permanent scar at the site where the tube exited the skin. The size of the scar can vary and depends on factors like the duration the drain was in place and individual skin healing.