Percutaneous drain hurting! Veterans?

[acc929]

Hi all

I've had a percutaneous drain in since march 23 for an abscess (collapsed, but hairline fistula still there) located in my right lower quadrant near my neo-terminal ileum (resection 2003). I'm going in for surgery to remove the fistula/strictured bowel next Friday. The drain was doing fine for quite a while and not bothering me that much after having gotten used to it. A couple days ago I noticed some somewhat-viscous light-yellow fluid leaking out around the insertion site when I was changing the bandage. Called my doc and he said it might be a bit of bowel fluid, not to worry (but to keep an eye out for fever/chills, i'm on loads of antibiotics already), but that this fluid can really irritate the skin so to put some vaseline/neosporin around the wound. When I was doing this last night I noticed a hardened area under the skin (no visible inflammation) and so my doc told me to go to the ER. Got a CT scan and it looked clean - everything is draining as before and the drain is still in place - just with a bit of inflammation (just tapered off prednisone, no big surprise, going back on a very low dose). Has anyone with longer-term drains in experienced this kind of issue? Any tips with how to maybe prevent or alleviate the pain other than the meds? It's really quite uncomfortable. They sent me home from the ER with tramadol and I'm kind of like really guys :/ but ok. It's not so bad in the morning and bothers me more as the day goes on. Any insight/tips/similar experiences from veterans of the drain/bag situation would be great. It's sort of alarming to have a tube in you for an extended period of time for the first time and I'm pretty wary of the whole thing, freaks me out a bit. Help! :confused2:

 

[DustyKat]

Hey Claire,

I don't have Crohn's so can only come to this from the perspective of looking after my son's percutaneous drain.

Matt had a drain in for 3 months and I know it was uncomfortable for him but I can't really say how painful. I know when he was discharged from hospital, where Panadol 1grm x4 daily is stock standard baseline pain management, was ceased I decided to put him back on a regime of Panadol 1grm x2 daily and then added doses as required. I also had him on Temazepam (sleeping tablet) when needed too as he found sleep difficult to come by as well and to me lack of sleep only adds to the issues of dealing with a drain.

The discharge you describe sounds like serous ooze to me which is normal in the healing process.

Do you flush your drain?

I was flushing Matt's drain twice a day and found that after about two weeks it started to leak around the drain, this was when he was in hospital and they were unconcerned about it. I personally think it had to do with the cavity being drained and starting close up.

The discharge he had on the dressing varied over the months, sometimes none, sometimes what you speak of. Now I don't know how enthusiastic you will be to do this, :lol:, but if I was unsure of the origins of the discharge I would smell the dressing. That way I could tell if it was bowel (faecal smell) or wound, it never did have a faecal smell.

He also would have times when his skin would be red immediately around the drain site and then other times it would be less so. I would not be concerned if redness does extend beyond a small circular area around it. He also had piece of 'tissue' that came out beside the drain, like a herniation/bulge, and that stayed there for nigh on two months. It never got worse but would go down in size and then back up again.

I hope some of that helps!

Dusty. xxx

 

[DustyKat]

PS. I know bigtruck and 21years have dealt with intra abdominal abscesses and drains so will tag them into this thread.