At 4 weeks post abdominoplasty, my drainage is still 60cc/day. What else can be done and what likely outcome am I looking forward to at this point?
I am a healthy 42 years old with large weight loss (without surgery) 3 years ago.
Answer: Pronlonged drain output after Tummy Tuck AS the other physicians have said, 4 weeks is a long time because most drains come out at 1-2 weeks in over 90% of patients. Having said that, occasionally I have had a patient in whom drainage persists far longer than that and I take each patient as an individual and discuss the options. Therefore you should discuss this with your surgeon whose management options may differ from mine. In these situations, I have clamped off the drain for several hours to try to "train" the body to absorb the fluid. After several hours, I place the drains to bulb suction and measure the quantity to see if their body responds. If it does, I will remove the drain with relative confidence. In situations where it does not, I would remove one drain at a time and watch the response. Usually by 4 weeks, I have done this because the drains begin to cause discomfort at the exit site. I inform patients they may need to come back for repeated aspirations if the fluid recurs. Fortunately the skin tends to be numb. Repeated aspirations usually result in successful management despite the incovenience of multiple trips to the office.
Helpful 12 people found this helpful
Answer: Pronlonged drain output after Tummy Tuck AS the other physicians have said, 4 weeks is a long time because most drains come out at 1-2 weeks in over 90% of patients. Having said that, occasionally I have had a patient in whom drainage persists far longer than that and I take each patient as an individual and discuss the options. Therefore you should discuss this with your surgeon whose management options may differ from mine. In these situations, I have clamped off the drain for several hours to try to "train" the body to absorb the fluid. After several hours, I place the drains to bulb suction and measure the quantity to see if their body responds. If it does, I will remove the drain with relative confidence. In situations where it does not, I would remove one drain at a time and watch the response. Usually by 4 weeks, I have done this because the drains begin to cause discomfort at the exit site. I inform patients they may need to come back for repeated aspirations if the fluid recurs. Fortunately the skin tends to be numb. Repeated aspirations usually result in successful management despite the incovenience of multiple trips to the office.
Helpful 12 people found this helpful
Answer: Maintain open communication with your surgeon! The vast majority of abdominoplasty patients have their drains removed within two weeks of their surgical procedure. We generally wait until the drainage has dropped below 25cc in a 24 hour period. Unfortunately, some patients have persistent drainage for longer periods of time. In some cases we’ve seen patients drain for four to six weeks. When this situation arises we worry about the potential for infection, since these drains are a two way street.When this situation arises we continue the use of compression garments and minimize activity levels. Rarely sclerosing agents are used to decrease drainage.Occasionally none of these treatments work and the surgeon is left with a difficult decision. In these cases, drains may actually stimulate drainage. Under these circumstances, the surgeon may elect to pull the drains even though the drainage is still high. If fluid accumulates percutaneous aspiration can be used to address the problem.It’s important to maintain close contact with your surgeon. Your surgeon should be able to formulate a plan that successfully manages this problem.
Helpful 2 people found this helpful
Answer: Maintain open communication with your surgeon! The vast majority of abdominoplasty patients have their drains removed within two weeks of their surgical procedure. We generally wait until the drainage has dropped below 25cc in a 24 hour period. Unfortunately, some patients have persistent drainage for longer periods of time. In some cases we’ve seen patients drain for four to six weeks. When this situation arises we worry about the potential for infection, since these drains are a two way street.When this situation arises we continue the use of compression garments and minimize activity levels. Rarely sclerosing agents are used to decrease drainage.Occasionally none of these treatments work and the surgeon is left with a difficult decision. In these cases, drains may actually stimulate drainage. Under these circumstances, the surgeon may elect to pull the drains even though the drainage is still high. If fluid accumulates percutaneous aspiration can be used to address the problem.It’s important to maintain close contact with your surgeon. Your surgeon should be able to formulate a plan that successfully manages this problem.
Helpful 2 people found this helpful
December 22, 2013
Answer: Continuation of drainage through drains following a tummy tuck after 4 weeks Continuation of drainage following a TT is one of the uncommon complications occasionally seen. Drains will continue draining for months until they become clogged. The negative pressure from the drain bulbs will suction the fluid out of the lymphatics and tissue until the suction itself is discontinued. 30 ml of clear drainage per drain is an acceptable amount to start backing out the drains. An alternative is to remove the suction device from the drains and let them gravity drain. With either techniques I have found that the drainage will diminish to the point that they can be removed, providing you do not have an infection and the drainage is clear and not red, as in blood. This of course has to be done by your PS, so these are only suggestions.Good luck.
Helpful 1 person found this helpful
December 22, 2013
Answer: Continuation of drainage through drains following a tummy tuck after 4 weeks Continuation of drainage following a TT is one of the uncommon complications occasionally seen. Drains will continue draining for months until they become clogged. The negative pressure from the drain bulbs will suction the fluid out of the lymphatics and tissue until the suction itself is discontinued. 30 ml of clear drainage per drain is an acceptable amount to start backing out the drains. An alternative is to remove the suction device from the drains and let them gravity drain. With either techniques I have found that the drainage will diminish to the point that they can be removed, providing you do not have an infection and the drainage is clear and not red, as in blood. This of course has to be done by your PS, so these are only suggestions.Good luck.
Helpful 1 person found this helpful
July 24, 2015
Answer: Stop Drainage
The fact that you have had your drains for 4 weeks is some what normal usually in most patients the drains come off after 1 week or 1 week and a half , but it does happen usually aside from the fact that it happens in large surgeries it is also caused when to much movement is made when the patient does not follow the indications properly which is doing the minimum activity that causes there to be more accumulation of liquid. But if you are now draining 60 cc your are ready to take them out and with lymphatic massages or aspirating the liquid that you have left.
Hope this helps , Regards
Helpful 2 people found this helpful
July 24, 2015
Answer: Stop Drainage
The fact that you have had your drains for 4 weeks is some what normal usually in most patients the drains come off after 1 week or 1 week and a half , but it does happen usually aside from the fact that it happens in large surgeries it is also caused when to much movement is made when the patient does not follow the indications properly which is doing the minimum activity that causes there to be more accumulation of liquid. But if you are now draining 60 cc your are ready to take them out and with lymphatic massages or aspirating the liquid that you have left.
Hope this helps , Regards
Helpful 2 people found this helpful
December 29, 2015
Answer: Continue using drains for optimum healing I am sorry for your continued drainage. Unfortunately increased drainage is seen in larger tummy tucks. I always use drains on my abdominoplasties and feel it is essential for optimum wound healing. If you were my patient I would l continue using the drains until they have drained at less than 30 cc for 2 continuous days. I suggest you consult with your surgeon if anything can be injected into the drain ports to sclerose the cavity. With patients that have persistent drainage from their wounds, I sometimes inject a sclerosing antibiotic into the drain site to help promote rapid collapse of the fluid chamber. It is also possible that you have developed a seroma in your abdominal cavity. You and your surgeon need to discuss this possibility and to determine the next step. Other less invasive procedures include wearing a tight abdominal binder to maximize external pressure on the wound. Thank you, J. Timothy Katzen, MD, FACS
Helpful 2 people found this helpful
December 29, 2015
Answer: Continue using drains for optimum healing I am sorry for your continued drainage. Unfortunately increased drainage is seen in larger tummy tucks. I always use drains on my abdominoplasties and feel it is essential for optimum wound healing. If you were my patient I would l continue using the drains until they have drained at less than 30 cc for 2 continuous days. I suggest you consult with your surgeon if anything can be injected into the drain ports to sclerose the cavity. With patients that have persistent drainage from their wounds, I sometimes inject a sclerosing antibiotic into the drain site to help promote rapid collapse of the fluid chamber. It is also possible that you have developed a seroma in your abdominal cavity. You and your surgeon need to discuss this possibility and to determine the next step. Other less invasive procedures include wearing a tight abdominal binder to maximize external pressure on the wound. Thank you, J. Timothy Katzen, MD, FACS
Helpful 2 people found this helpful