I first encountered Jackson Pratt (JP) drains back in the 1970s, while in nursing school at Boston College caring for postop patients following mastectomy or hernia repair. Over several decades as a visiting nurse, I’ve instructed innumerable patients about drain care--how to strip the drains, measure the output, and ensure the grenade shaped bulbs are compressed to provide suction.
In 2012, following my own bilateral mastectomy, I was discharged from Mass General as a patient and went home with four drains. It occurred to me that in over forty years, little about JP drains has improved. The awkwardness of stripping the tubing continues to be a challenge. The weight of accumulating drainage in the bulbs puts tension on the tubing, causing discomfort and the risk of spillage. Anchoring the drains and tubing inside clothing or for showering requires trial and error for most. The suction is optimal only briefly, after emptying and measuring the output, when the bulb is squeezed by hand and recapped; once drainage begins to inflate the bulb and blood fibrin in the tubing becomes clotty again, the suction is diminished.
Like most patients, I looked forward to having my drains removed. Four years later, axillary metastases required I undergo a lymph node dissection, which meant another bulky postop JP drain. Unfortunately, after the drain was removed I developed a seroma--an accumulation of serous fluid under the skin, requiring several additional visits to the surgeon’s office at MGH for needle aspiration.
The development of an improved device providing consistent suction to remove fluid and minimize the risk of seroma sounds long overdue. A low-profile device close to the body, more easily emptied and measured would be a significant improvement over the bulky JP “grenades” that hang awkwardly and are difficult to manage.
After being introduced to SOMAVAC I’m excited by the prospect that clinicians and patients may soon see a significant improvement in a postop drainage device. From a postop standpoint, a device with continuous suction will offer consistent drainage of the fluid accumulating between tissue layers that may promote earlier healing and seroma prevention. From a patient perspective, a compact drainage collection device with fewer steps and reduced risk of mishap will ease anxiety at an already stressful time. And from a nursing perspective, I envision improved clinical outcomes and patient satisfaction with SOMAVAC.
Laura Long, RN, PhD
VNA Care Liaison
Dr. Laura Long is an RN Liaison with VNA Care in Boston, MA. She is an instructor at the College of Holy Cross in Worcester, MA and in the Masters of Healthcare Administration program at Framingham State University. Laura has metastatic breast cancer (stage 3b) and is actively receiving care at Massachusetts General Hospital in Boston.