I Am 4 Weeks Postop and Still Have One Drain, Draining 40-50cc/day. Is That Normal?

Sometimes persistent drainage is related to excessive activity that prevents the skin flap from adhering to the underlying abdominal wall tissues. Sometimes there may be contamination or sub-clinical infection of the drain itself, which can cause persistent drainage. Removal of the drain is sometimes all that is necessary in this situation, but as often as not, another drain will need to be reinserted.

If the drainage is clear and yellowish (not cloudy or foul-smelling), perhaps your surgeon will consider sclerotherapy, where tetracycline is dissolved in a small amount of saline and inserted into the drain tube with mild pressure (never forced). This causes irritation and inflammation that can aid the tissues in "sticking" down and allowing the drainage to diminish until appropriate for removal. Every surgeon uses a slightly different amount, but I generally feel that less than 25-30cc per 24 hours is the time to pull the drain. Of course, a check to see if you are retaining fluid after drain removal (sclerotherapy or not) is a good idea within 3-7 days.

If a pseudobursa is allowed to persist for too long, sometimes re-operation to remove the fluid pocket is necessary to allow things to completely heal. Quilting sutures can aid the healing process, both at the initial surgery, and at pseudobursectomy, if needed. Good luck!

We usually have our drains at 20cc each or less by day 7-10.  This very unusual and should be a concern by your doctor unless there is a condition they are aware of and this is what they expect.

Placing a drain during an abdominoplasty or tummy tuck is a routine procedure. Depending on the surgeon there may be one drain or multiple drains. Usually the drain comes out around during the first week, but occasionally the surgeon may need to keep it for a longer period of time because the drain may be putting out a significant amount of liquid. In my practice, I tend to remove the drain when they produce less than 50cc a day. However it is still your surgeons’ preference, but 40-50cc a day seems like a reasonable amount to remove the drain.

It's unusual to keep a drain in that long-I would check with your PS to see what the reason for this is-typically 4-6 days is the average

Not very common but in my 34 years I have sen this issue in a handful of patients. Best to try to remove old drain and re inert an new one in a minor surgery. Or seek a second in person opinion.

We rarely use a drain any longer for tummy tuck, and when we do we like to remove the drain by about five days after. The drain is hard to tolerate longer and becomes an infection risk over a longer period of time. Hard to imagine how you might have fared a month with a drain in  place after your tummy tuck. Time to take it out.
Best of luck,
peterejohnsonmd

The usual period for leaving drains following a tummy tuck is 4- 6 days. Occasionally this period may need to be prolonged. It is  unusual to keep the drains in fo 4 weeks and to still have 40-50cc of drainage per day. You should consult with your surgeon to find out what is happening and to also identify the nature of the drainage. Is it clear, bloody or cloudy? You may need to have a culture taken.

Using a drain is the current standard. It is uncommon to have it stay in for 4 weeks. I recommend antibiotics if the drains are in longer than 2 weeks. Compression is important but most of all that you have not been or not currently overdoing it. I find this to be the most common reason drainage does not come down quickly. Think of a fractured bone that needs to be casted or plasted so the ends can fuse. This is also true with the reconnecting of the skin flap. A variety of other reasons contribute to drain fluid: body size, amount of tissue removed, surgical technique, and use of cautery are some factors. We tend not to leave drains in past 4 weeks regardless of the amount. Should fluid accumulate, that would need to be dealt with.