Jackson-Pratt (JP) Drain

What is a Jackson-Pratt (JP) drain?

A Jackson-Pratt (JP) drain is a thin, flexible tube with a bulb on the end that drains fluid away from your wound after surgery. After surgery, wounds ooze and shed cells and fluids, like blood and lymphatic fluid (lymph). A JP drain moves the fluid from your wound to the bulb outside your body. Removing the fluid helps you heal faster. It may reduce your risk of an infection if you care for it (and your wound) properly.

How does a JP drain work?

A JP drain uses suction to gradually draw fluid from your wound. It has three basic parts:

• A flattened end with holes that goes inside your wound so fluid can seep in.
• Flexible tubing that allows fluid from the wound to travel to a collection bulb outside your body. Healthcare providers usually secure this part of the drain to your skin with a suture.
• A lemon-shaped collection bulb that draws fluid out when it’s compressed (squeezed). The bulb has a stopper that creates an airtight seal. You remove the stopper to empty the fluid.

In technical terms, a JP drain is a closed, active drain system that uses negative pressure to move fluids. It sounds complex, but it’s as simple as this: A squeezed bulb creates pressure that pulls liquid downward from the wound, through the tubing, to the collection bulb.

You’ll need to empty the bulb when it’s about halfway full. Then, you’ll need to squeeze it again to ensure it’s compressed. JP drains are usually compressed to allow the drain to suction. Although it’s rare, some JP drains rely on gravity to drain. (Your surgical team will specify.)

When would you need a JP drain?

JP drains are the most common type of surgical drains. Surgeons use them to drain fluid after several procedures, like:

• Abdominal surgery, including hernia repair surgery.
• Breast surgery, including breast cancer surgery and top surgery.
• Chest surgery, including procedures to remove fluid buildup in your chest, like pleural effusion.
• Thyroid surgery, including thyroid removal surgery (thyroidectomy).
• Cosmetic and plastic surgery, including reconstructive surgery.
• Lymph node removal (lymphadenectomy).

JP drains hold less drainage than the other type of closed suction drain, a hemovac drain. The amount of fluid a JP drain can hold depends on the specific model. Generally, it holds from 25 to 50 milliliters (mL) at a time.

How do I care for my JP drain?

Caring for your drain involves emptying it and keeping it compressed, so it continually drains. You should log information about your drainage. A healthcare provider may do this for you in the hospital. They’ll teach you how to do it yourself if you go home with a drain.

You should also clean your wound and change the dressing according to your provider’s instructions.

It’s a good idea to attach the bulb to your clothes so that it doesn’t accidentally get pulled out.

Emptying the drain

Have the materials on hand you’ll need to empty your drain, including a clean towel or two, an alcohol wipe, gauze and a measuring container. Your provider will send you home with the measuring container.

1. Wash your hands. Use soap and warm water to wash your hands for at least 20 seconds. Use a towel to dry your hands and turn off the faucet. Or, you can use an alcohol-based hand sanitizer to clean your hands. If you go this route, pump a dime-sized amount of hand sanitizer into your palm and rub it into both hands until they’re dry.
2. “Milk” the tubing. With your nondominant hand, pinch the tube about a finger’s length away from the insertion site. Hold it firmly in place. This prevents feeling a tug at your wound when you “milk” the tube. To do this, place your dominant hand’s thumb and index finger below where your other fingers are pinching the tube. Slide your fingers down the tubing toward the bulb. Using an alcohol wipe can help your fingers glide more easily.
3. Empty the fluid. Once you’ve forced the fluid into the collection bulb, it’s time to empty it. Remove the stopper and pour the fluid into a measuring container. Avoid touching the hole with your fingers. This could introduce bacteria into the drain.
4. Reset (squeeze) the collection bulb. Squeeze the bulb so that it’s completely compressed. While the air’s still out, replace the stopper to create an airtight seal. The bulb should feel flat in the middle.
5. Wash your hands. Repeat step one.

Repeat the procedure if you have more than one drain. For example, you may need two JP drains after a mastectomy.

Logging details about the drainage

Jot down information about your drainage, including what time you emptied your drain, how much drainage there was and what it looked like. These details let your provider know how you’re healing.

If you’re healing, your drainage should decrease daily. Drainage from a wound changes color as it heals. Look for these color changes that let you know you’re healing.

• Dark red: It’s normal for drainage to be bloody at first.
• Lighter red or pink: Drainage lightens as the wound heals.
• Pale yellow (straw color) or clear: Drainage that goes from red to pale yellow or clear is a sign you’re healing. This is called serous drainage.

The drainage can also alert your provider of complications, like an infection. For example, drainage that begins to lighten but then returns to dark red can signal that you’re bleeding. Drainage that’s milky white or smelly is a sign of infection.

Changing your dressing

Follow your provider’s guidance on when and how often you should change your dressing. They’ll teach you how to do it. It’s a good idea to assemble all materials you’ll need beforehand, which may include clean towels, a piece of gauze with a slit halfway down the middle, surgical tape and wound cleanser.

1. Wash your hands.
2. Remove and discard the old dressing, taking care not to pull the drain.
3. Wash your hands again.
4. Clean the wound with soap and water or wound cleanser. (Your provider may say it’s OK to clean it in the shower, but avoid soaking in a tub or pool if you have a JP drain). Rinse and pat dry with a clean towel.
5. Slide the gauze with the slit underneath the tubing at the insertion site and secure it with tape.

How do I keep a JP drain in place?

The collection bulb has a loop where you can insert a safety pin to attach it to your clothing, like a shirt or gown. Don’t pin the drain to your pants or belt loops. It’s easy to forget they’re there, and you may accidentally pull them out.

How often should I empty my drain?

You should empty the drain as often as possible so that the bulb stays compressed. In general, you’ll need to do this every four to six hours the first few days until the amount decreases.

How long do JP drains stay in?

JP drain removal requires a visit to your healthcare provider. Keep the drain in place until your healthcare provider tells you it’s time to remove it. Usually, they don’t stay in for more than two weeks, but this depends on your unique case.

Ask your healthcare provider what to expect before you leave the hospital.

When should I call my healthcare provider?

Contact your provider immediately if you notice signs of an infection, including:

• A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or more.
• Redness, swelling, warmth or increased pain at the site.
• Red streaks coming from the site.
• Drainage that’s smelly, green, milky white or thick.

Call your healthcare provider if your drain comes loose or is no longer draining fluid. They may need to secure it or ensure it’s airtight. Contact your provider if the tube becomes dislodged or stops holding suction and fills with air. Look for these signs:

• The drainage increases for two days straight (it should be decreasing).
• The fluid returns to a dark or bright red after lightening (this is a sign that you’re bleeding).
• Fluid starts coming out of the incision site (your provider may need to clear your drain).

Sometimes, after providers remove JP drains, fluid collects and swells at the surgical site (wound). This fluid is called a seroma. This isn’t an emergency, but you should alert your provider.

Is a JP drain an open or closed drain?

It’s a closed drain. Think of the JP drain as a closed system that relies on air pressure changes within the system to pull fluid from a wound. Instead of draining outside your body and onto dressing (as with open drains, like the penrose drain), the fluid collects in a bulb that pulls fluid out when it’s compressed.