Drain output is very little but it's an odd color (Like dark apple cider). Is that normal?

Question

I'm 13 days post op from inverted T tummy tuck and have had 2 of my 3 drains removed. The final drain will probably be removed tomorrow at my appointment but suddenly the color changed a day or two ago. I'm only getting 13 cc or less per day. No fever and not really a foul smell but the drainage site does hurt. Is this an infection or just the end of the drainage cycle?

Donovan Rosas, MD · Answer

The quality of drain output is as variable as the quantity of drainage. Typically it will start out predominantly bloody and then transition to a serosanguinous mixture (part blood/part serous fluid). Eventually it will settle at a tea colored or clear yellow drainage. Occasionally, darker output can be associated with a dissolving clot or hematoma.Once a drain reaches < 30 cc over consecutive 24 hour periods, it will typically be removed. However, surgeon protocols will differ.As always, discuss your concerns with your board certified plastic surgeon (ABPS).

Kenneth Dembny, II, MD · Answer

Thank you for your question.
Immediately following a tummy tuck procedure, the drain output usually is bright red.  This is related to the amount of blood in the drainage.  Over time, the color will change to a lighter and thinner red, as the amount of blood in the drainage decreases.  When there is essentially no more blood in the drainage the color will change to a relatively clear red-orange or orange coloration, and may finally settle on a yellow color.
  
In addition to the color change, you may notice some clots or other coagulated protein in the drainage tube. This is a normal occurrence. I typically have my patients strip the drainage tube twice dialy, before emptying the drainage bulb, to remove these clots and protein and keep the flow study.
  
When the drainage color is a dark red-black, or dark red-brown, this is usually due to blood clots and/or a hematoma that are breaking down (liquefying).
  
Each surgeon will have his or her individual preference, but following a tummy tuck the drainage tubes are likely to be removed when the total drainage is < 30 cc per day.
  
In this situation you describe it is good that he do not have a fever, and that the drainage does not have a foul odor.  The darker coloration is likely due to a bit of old blood.  You should however contact your plastic surgeon for evaluation.
  
Irritation at the drain exit site can be secondary to inflammation that occurs when the drainage tubes are left in for a longer period of time.  Depending upon how securely the drainage tube was sewn into place, movement of the tube back and forth through the skin can also be irritating and painful.
  
Overall it sounds like you are doing fine. Best wishes for a speedy recovery.

Steven Wallach, MD · Answer

If your drainage is pretty low then it sounds like it is time to remove it. Sometimes the drain exit site gets irritated when the drain is in this long.  Am evaluation in person is key to properly assessing you.

Marc J. Salzman, MD, FACS (retired) · Answer

Darker color drain output, usually of a chocolate syrup consistency, is usually due to old blood that is been broken down and now liquefied. This requires an in person examination. Your plastic surgeon would be the best person to evaluate what the change in color of your output means. Congratulations on your surgery.

Drain output is very little but it's an odd color (Like dark apple cider). Is that normal?

Answers (4)

Answer: Dark colored drain output

Answer: Dark colored drain output

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Drain output is very little but it's an odd color (Like dark apple cider). Is that normal?

Answers (4)

Answer: Dark colored drain output

Answer: Dark colored drain output

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Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.