How to care for surgical drain tube after operation

　　The surgical drain tube indwelling has become one of the commonly used adjuvant treatments in surgical operations. 2-3 drainage tubes are often used to drain patients after clinical surgery. Clinical practice has shown that this method can effectively promote the discharge of harmful substances and effusion in patients, ensure the unblocked lumen, and thus reduce the incidence of complications and promote the recovery of patients.

　　Care for the surgical drain tube may vary depending on the patient's disease type, location of the lesion, and surgical procedure. High quality postoperative surgical drain tube care is an important basic measure to ensure proper drainage tube placement, improve postoperative safety and promote recovery. Accidental, unreasonable or wrong surgical drain tube care will directly threaten patients' life safety.

　　The main points of care for the surgical drain tube are summarized as follows:

　　Keep the surgical drain tube clear

　　Generally, after hepatobiliary surgery, the surgical drain tube is placed in the lower segment of the hepatobiliary duct, which is then inserted out of the body and fixed on the abdominal wall. It should be noted that the position of the drainage bag should not seriously affect the patient's turning over. When the patient returns to the ward, the number and location of the surgical drain tube should be checked again to ensure that the surgical drain tube is clear for effective drainage. After the procedure is complete, the surgical drain tube should be squeezed every hour to effectively prevent the tube from becoming blocked, twisted, compressed, or folded.

　　Prevent clogging of surgical drain tube

　　The drainage of patients undergoing hepatobiliary surgery is quite complicated. Necrotic tissue, blood clots, bile fluid and other substances may cause blockage of the surgical drain tube. Nursing staff need to squeeze the surgical drain tube regularly. If the bile duct is bleeding, flush the bile duct wall with a 1:1000 norepinephrine saline solution to avoid accelerating clot formation. In the process of rinsing need to pay attention to gentle movements, rinsing pressure and rinsing fluid should be moderate. The location of the drainage bag should be moderate to avoid excessive position leading to bile reflux and infection, and should also avoid too low and excessive loss of bile. Therefore, the drainage bag should be below the midaxillary line while the patient is supine and should be placed under the abdominal incision during movement.

　　Prevent the surgical drain tube from falling off

　　The nursing staff should always check the extracorporeal surgical drain tube fixation, which is usually done by a combination of tape and safety pins or by ligating leather stitches. The location of the drainage bag should follow the principle that it does not affect turning over and is easy to see. Generally, it is hung in the central bar beside the bed. Instruct the patient's family members to hold the drainage bag well when the patient is moving or turning over. It must be lower than the mouth of the surgical drain tube, and strengthen the observation of the surgical drain tube to avoid retrograde reflux. And strengthen restraint and supervision of patients to prevent spontaneous extubation. In addition, for obese patients, abdominal wall fat will be consumed quickly after surgery, and thus the skin of the abdominal wall will be relaxed. Therefore, it is necessary to avoid the loss of surgical drain tube due to the downward twitch of the skin.

　　Watch the drainage closely

　　Generally, 2 days after surgery, the drainage fluid was concentrated in 100 ~ 250 ml /d, with light yellow color and a certain turbidity, and then slowly changed to clear yellow; 3 ~ 4 days after surgery, the drainage volume can be increased to 500 ml /d, and then decreased day by day. If the drainage flow is increased and accompanied by blood, it indicates that there may be active bleeding. If the light yellow drainage volume increases, it indicates the possibility of ascites. If purulent flocculent is found, it may indicate the presence of abdominal infection. A sudden decrease or disappearance of drainage flow indicates obstruction or dislocation of the surgical drain tube. The above conditions should be discovered in time, reported to doctors, and targeted measures should be taken.

　　Prevent complications

　　After the operation, closely observe the dynamic changes of patients' vital signs, and promptly inform the doctor in charge of any discomfort. In addition, the skin around the surgical drain tube should be disinfected when replacing the drain bag, and sterility should be strictly enforced during replacement. If a patient needs to leave the surgical drain tube in place, explain the surgical drain tube nursing methods and precautions to the patient and their family members, and instruct the patient not to exercise excessively to avoid the surgical drain tube escaping.

　　Extubation care

　　The surgical drain tube was removed after the patient met the surgical drain tube indication. 1 day after extubation, try to rest in bed and clean the surrounding skin.

　　Psychological nursing

　　The psychological state of patients after surgery can directly affect the postoperative recovery. After surgery, patients should be provided with a quiet, comfortable and beautiful ward environment. In the process of nursing, more communication with patients and their families, understand the dynamic changes in patients' psychology, encourage, care about the changes in patients' condition and psychological changes, in order to establish a good doctor-patient relationship. Patiently answer patients' questions and concerns. Explain to patients the purpose and importance of placing surgical drain tube after surgery, introduce past successful recovery cases, eliminate patients' nervousness and fear of surgical drain tube after surgery, and increase patients' confidence in overcoming the disease.

　　surgical drain tube indwelling is a common measure in surgical operation, which has positive effects on patients' prognosis and condition improvement. Scientific, reasonable and effective surgical drain tube care has positive and important significance for the early recovery of patients, the reduction of postoperative complications, the improvement of nursing quality and the improvement of patients' quality of life.

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