Abdominal drains not always working
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My husband is going for his 7th internal/external biliary drain change on Friday. They either stop draining or they leak, both of which you have described. They are a royal pain, but they do help the Bilirubin count to lower.
I would not use Tegaderm even though I love the stuff, because it allows no air in. We just use a gauze sponge and tape. I am always worried about his skin breaking down.
Flushing has caused us no end of problems. Either it caused it to leak faster, or it would just come out of the insertion site. Our Interventional Radiologist said to stop flushing since it was draining well without it. But it is in the nature of these biliary drains to either clog or leak or both. It is easy for them to be accidentally pulled out of position just by moving around.
Does your husband have a Statlock and a stopcock? They had to put both on David just to stop it from moving. He drains about 250cc’s a day. Anything else drains internally to the small intestine.
The Internet is your best source of information if you have the time to look.
Best of luck to you and your husband.
JeanThanks for all the responses. I appears we will probably get one of the drains replaced this week. We are lucky, my husband has no sign of infection, the drain is still working, but it leaks. My biggest concern is the potential problems having to his skin. I have been using tagaderm to cover the drain, but I fear that changing it every day will eventually cause problems with his skin. Hopefully, with a little tweaking, we will get this drain operating as it should. It took three tries with his other drain. Thanks for all the help and support. Just when we get a new “normal”, something else seems to pop up. I feel so inadequate, as I really do not know how to deal with many of these issues. But we are learning………..
Sharon –
Is the tube stitched in place? Sometimes if they aren’t stitched in place then they can move around and then it causes a mechanical blockage meaning that it is up against something. If it stitched in place then it may very well still be related to positioning. Have his take a deep breath as you try to flush, lay down or even just lift his arms up. Sometimes that will take care of it. Also since he is obviously getting bile on his skin, make sure you keep the area well protected….I would apply some sort of barrier cream around the area…..using something that has dimethicone in it as it will repel the bile away from the skin. Keeping the dry dressing on it will help a lot too.
Stay in touch with the interventional radiology and keep them posted on how often it plugs….may need to be changed and have a bigger size put….yes I know a total pain in the rear but will keep it from plugging up.
I know how frustrating it can be. My husband had one put in 5 days before his resection. We were only home for two days before we had to make the trip to the hospital for it. In my husband’s case instead of draining a liter of fluid a day (which is normal), he drained 6 or 7 liters….we lost count…but he ended up really sick, dehydrated and in serious trouble. Then about 5 days after surgery they replaced it with a bigger drain because it got plugged. Then they turned around just before we went home and capped the darn thing. UGH!
Watch for the signs of infection and keep in touch with the interventional radiologist/
KrisV
Hi Sharon,
Sometimes drains can become lodged against the wall of the abdomen or organ they are in, or depending on positioning sometimes they are not in a fluid pocket or there is no fluid to drain for brief periods. The fact that you are unable to flush the drain when this happens sounds like the former.
You can attempt to gently flush the drain, having your husband shift positions (sitting, laying, changing sides) and reattempt. It is important not to force the flush, but you can try it again a little later.
Continue to look for any signs of infection daily. Clean around the site when it leaks (another indication the tube may be blocked, including pushed against a wall), keeping it clean and dry. And look for fever, chills, nausea, new or increased pain, a rise in heartbeat or breathing, or even an unusually low temperature as this can sometimes signal sepsis or a more global infection. Also look for a change in the drainage including color, consistency, clarity, etc. Report any of those to your doctor, there should be someone on call to answer your questions.
Make sure to fill out and print our patient emergency card , this will be valuable in reminding you when to go to the emergency room and will help your doctor identify the issues your husband may be experiencing and the appropriate treatment.
Hope this helps!Hi Sharon,
Not had a lot of experience personally with drains but I know that others will be along soon to help share their experiences of drains with you. You are right though to keep a very close eye on this and of course to watch for signs of infection etc and should it become necessary a trip to the ER would not be out of order either.
I so hope that things will start to work as they should with the drain ASAP. I have this link as well on drains and hope it is of use to you.
My best wishes to you and your husband,
Gavin
My husband has had 2 drains in his liver for about 3 weeks. One of the drains has had to be replaced twice already, as i wasn’t able to flush it. They put in a bigger drain, and now it is working. His other drain will periodically quit draining, and all of the fluid come out through the hole where the drain is placed. When this happens, I am also unable to flush the drain. I clean the area, redress it, and within 8 hours, the drain starts working again. Has anyone else had a similar experience? There is no fever, so no obvious infection. The first time this happened, it was on Friday before Memorial day, and when I talked with the interventional radiology team, we decided to keep a watch, and if it continued to malfunction, take a trip to the ER. The situation resolved itself, and the drain functioned properly until last evening. My husband is very reluctant to go in to get it checked as long as it seems to correct itself. Has anyone else had a similar experience?
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