What surgeries require drains after?

September 24, 2025 •

4 min read

Following certain surgical procedures, the body naturally produces excess fluid and blood, which can accumulate around the surgical site. To prevent this build-up and promote optimal healing, a surgeon may place a surgical drain. This guide will explore what surgeries require drains after and explain the crucial role they play in a smooth recovery.

Quick Summary

Many surgeries, particularly those involving extensive tissue removal or large dissections, require temporary drains to prevent fluid accumulation, reduce swelling, and accelerate the healing process. Common examples include abdominoplasty, breast surgery, and certain orthopedic procedures where the removal of excess fluids or blood is necessary for a successful recovery.

Key Points

Purpose of Drains: Surgical drains prevent fluid accumulation (seromas and hematomas) after surgery to promote faster, more complete healing.
Common Procedures: Drains are often required for surgeries with extensive tissue removal, such as abdominoplasty, breast reconstruction, mastectomies, and joint replacements.
Types of Drains: Common types include closed-suction systems (Jackson-Pratt and Hemovac) and passive systems (Penrose), with the choice depending on the type of surgery and fluid output.
At-Home Management: Patients are typically taught to empty the drain, measure the fluid, and clean the insertion site to prevent infection.
Monitoring is Key: Tracking the amount and color of drainage is important for gauging healing progress and alerting the medical team to potential complications.
Temporary Necessity: While drains can be uncomfortable, they are temporary and crucial for achieving the best surgical outcome with minimized complications.

Understanding the Purpose of Surgical Drains

Surgical drains are an essential tool in many post-operative care plans, serving several key functions that promote healing and minimize complications. After surgery, the body's natural response to trauma is to produce fluid, which can be a mixture of blood and lymph. This fluid can collect in the "dead space" created by the surgical procedure, leading to several potential problems if not managed correctly.

The primary purpose of surgical drains is to channel this excess fluid away from the wound site. This serves multiple benefits, including:

Preventing Seromas and Hematomas: Drains prevent the build-up of clear, serous fluid (seromas) and blood (hematomas), which can delay healing and increase the risk of infection.
Reducing Swelling: By removing excess fluid, drains help minimize post-operative swelling, leading to a more comfortable recovery.
Indicating Potential Complications: The output from the drain (amount, color, and consistency) provides your medical team with crucial information about your healing progress. Sudden increases in output or changes in color can signal a complication, such as bleeding or infection.
Promoting Tissue Adhesion: Removing fluid helps bring tissue layers back together, allowing them to heal more quickly and effectively.

Surgeries Requiring Drains: A Comprehensive Overview

Several types of procedures commonly require the placement of surgical drains, especially those with significant tissue dissection or large incisions. The specific type and number of drains can vary depending on the surgery and the surgeon's preference.

Common Plastic and Reconstructive Surgeries

Abdominoplasty (Tummy Tuck): This procedure involves the removal of excess skin and fat from the abdomen, creating a large area where fluid can collect. Drains are frequently used to prevent seroma formation and ensure the remaining tissue adheres properly.
Breast Reduction and Reconstruction: For both procedures, drains are often placed to remove excess fluid and blood, particularly when a significant amount of tissue has been manipulated or removed. This helps ensure proper healing and the desired cosmetic outcome.
Mastectomy: Following a mastectomy, one or more drains are typically placed to manage fluid accumulation, which is a common inflammatory response to the surgery.
Facelift and Neck Lift: These procedures involve lifting and repositioning skin and tissue, often requiring drains to prevent fluid buildup and promote a smoother, more refined contour.
Brachioplasty (Arm Lift): The removal of excess skin and fat from the upper arms can leave a dead space susceptible to fluid collection, making drains a common requirement.

General and Oncological Surgeries

Mastectomy (for breast cancer): As noted, this procedure often involves the removal of a large amount of tissue, necessitating drains for post-operative fluid management.
Pancreatectomy: In procedures involving the pancreas, drains are critical for removing pancreatic or biliary fluid to prevent fistulas (abnormal connections or leaks).
Thyroidectomy: For certain thyroid surgeries, drains may be used to prevent fluid buildup in the neck, which can cause pressure on the airway.
Complex Hernia Repairs: For large or complicated hernia repairs, drains may be used to remove fluid and minimize the risk of infection.

Orthopedic Surgeries

Total Joint Replacements: For procedures such as total knee or hip replacements, drains are often used to remove excess blood from the surgical site.

Comparing Common Surgical Drains


Feature	Jackson-Pratt (JP) Drain	Hemovac Drain	Penrose Drain
Mechanism	Closed-suction system using a bulb reservoir to create a vacuum.	Closed-suction system using a spring-loaded, cylindrical reservoir.	Passive system relying on gravity to drain fluid onto a dressing.
Usage	Most common type; versatile for various surgeries (plastic, general, cancer).	Used for larger surgical sites or orthopedic surgeries with high fluid output.	Best for small amounts of fluid or draining infected areas where suction isn't needed.
Reservoir	Soft, squeezable bulb reservoir.	Larger, spring-loaded, cylindrical reservoir.	No reservoir; fluid drains onto gauze.
Best For	Moderate fluid accumulation after procedures like breast surgery or abdominoplasty.	Extensive reconstruction or larger volume fluid management.	Draining abscesses or infected fluids that are thicker and don't flow easily.

Drain Management and Post-operative Care

Patients with drains are typically sent home with instructions for care, including how to empty and manage the drain. Proper hygiene and monitoring are critical to a smooth recovery and to reduce the risk of infection. Your care team will provide detailed guidance on:

Emptying the Drain: This involves releasing the vacuum, draining the contents into a measuring cup, recording the output, and re-creating the vacuum by compressing the bulb or spring mechanism.
Recording Output: Keeping a log of the daily drainage amount helps the surgeon track your progress and determine when the drain can be safely removed.
Cleaning the Site: Keeping the insertion site clean with soap and water can help prevent infection.
Signs of Complications: Knowing what to look for, such as increased redness, fever, or a sudden change in drainage color or odor, is vital for early detection of issues.

Conclusion: A Temporary Necessity for Optimal Healing

Surgical drains, while potentially uncomfortable, are a critical component of post-operative care for a wide range of procedures. By preventing fluid accumulation, they significantly reduce the risk of seromas, hematomas, and infection, ensuring a quicker and more effective healing process. Procedures involving large tissue removals or dissections, including abdominoplasty, breast reconstruction, and joint replacement, are among the most common requiring drains. Proper at-home management is key to their success, and any concerns should be promptly addressed with your healthcare provider. Understanding the role of drains can help prepare patients for a smoother and more successful recovery.

For more information on surgical recovery and patient support, a trusted source is the American College of Surgeons.

Frequently Asked Questions

Surgeries that commonly require drains include abdominoplasty (tummy tuck), breast reduction, breast reconstruction, mastectomies, facelifts, and certain orthopedic procedures like total joint replacements.

Surgical drains are necessary to remove excess fluid and blood from the surgical site. This prevents fluid build-up (seromas and hematomas) and reduces swelling, which promotes proper healing and reduces the risk of infection.

The duration drains stay in depends on the type of surgery and the amount of fluid being drained. They are typically removed when the drainage volume decreases to a low, consistent level, which can be days or a few weeks.

At home, you must regularly empty the drain bulb, measure the output, record the amount, and keep the drain insertion site clean. Your surgeon will provide specific instructions tailored to your procedure.

The most common types are the Jackson-Pratt (JP) drain, which uses a bulb for suction; the Hemovac drain, which uses a spring-loaded cylinder for more extensive suction; and the Penrose drain, which is a passive gravity-based system.

If your drain appears clogged, you can gently 'strip' or 'milk' the tubing to clear it, but always follow your surgeon's specific instructions. If it remains clogged or stops draining, contact your healthcare provider.

Most patients report minimal pain during drain removal. The process is quick, typically involving the removal of a single stitch and a gentle pull of the tube. You may feel some mild pressure or tugging, but pain medication is not usually required.