Closed suction drain with bulb

A closed suction drain is used to remove fluids that build up in areas of your body after surgery or when you have an infection. Although there is more than one brand of closed suction drains, this drain is often called a Jackson-Pratt, or JP, drain.

The drain is made up of two parts:

• A thin rubber tube
• A soft, round squeeze bulb that looks like a grenade

One end of the rubber tube is placed in the area of your body where fluid may build up. The other end comes out through a small incision (cut). A squeeze bulb is attached to this outer end.

Ask your health care provider when you may take a shower while you have this drain. You may be asked to take a sponge bath until the drain is removed.

There are many ways to wear the drain depending on where the drain comes out of your body.

• The squeeze bulb has a plastic loop that can be used to pin the bulb to your clothes.
• If the drain is in your upper body, you can tie a cloth tape around your neck like a necklace and hang the bulb from the tape.
• There are special garments, such as camisoles, belts, or shorts that have pockets or Velcro loops for the bulbs and openings for the tubes. Ask your provider what might be best for you. Health insurance may cover the cost of these garments, if you get a prescription from your provider.

Items you will need are:

• A measuring cup
• A pen or pencil and a piece of paper

Empty the drain before it gets full. You may need to empty your drain every few hours at first. As the amount of drainage decreases, you may be able to empty it once or twice a day:

• Get your measuring cup ready.
• Clean your hands well with soap and water or with an alcohol-based cleanser. Dry your hands.
• Open the bulb cap. Do not touch the inside of the cap. If you do touch it, clean it with alcohol.
• Empty the fluid into the measuring cup.
• Squeeze the JP bulb, and hold it flat.
• While the bulb is squeezed flat, close the cap.
• Flush the fluid down the toilet.
• Wash your hands well.

Write down the amount of fluid you drained out and the date and time each time you empty your JP drain.

You might have a dressing around the drain where it comes out of your body. If you do not have a dressing, keep the skin around the drain clean and dry. If you are allowed to shower, clean the area with soapy water and pat it dry with a towel. If you are not allowed to shower, clean the area with a washcloth, cotton swabs, or gauze.

If you do have a dressing around the drain, you will need the following items:

• Two pairs of clean, unused, sterile medical gloves
• Five or six cotton swabs
• Gauze pads
• Clean soapy water
• Plastic trash bag
• Surgical tape
• Waterproof pad or bath towel

To change your dressing:

• Wash your hands well with soap and water. Dry your hands.
• Put on clean gloves.
• Loosen the tape carefully and take off the old bandage. Throw the old bandage into the trash bag.
• Look for any new redness, swelling, bad odor, or pus on the skin around the drain.
• Use a cotton swab dipped in the soapy water to clean the skin around the drain. Do this 3 or 4 times, using a new swab each time.
• Take off the first pair of gloves and throw them in the trash bag. Put on the second pair of gloves.
• Put a new bandage around the drain tube site. Use surgical tape to hold it down against your skin.
• Throw all used supplies in the trash bag.
• Wash your hands again.

If there is no fluid draining into the bulb, there may be a clot or other material blocking the fluid. If you notice this:

• Wash your hands with soap and water. Dry your hands.
• Gently squeeze the tubing where the clot is, to loosen it.
• Grip the drain with the fingers of one hand, close to where it comes out of your body.
• With the fingers of your other hand, squeeze down the length of the tube. Start where it comes out of your body and move toward the drainage bulb. This is called stripping the drain.
• Release your fingers from the end of the drain where it comes out of your body and then release the end near the bulb.
• You might find it easier to strip the drain if you put lotion or hand cleanser on your hands.
• Do this several times until fluid is draining into the bulb.
• Wash your hands again.

Contact your surgeon if:

• Stitches that hold the drain to your skin are coming loose or are missing.
• The tube falls out.
• Your temperature is 100.5°F (38.0°C) or higher.
• Your skin is very red where the tube comes out (a small amount of redness is normal).
• There is drainage from the skin around the tube site.
• There is more tenderness and swelling at the drain site.
• The drainage is cloudy or has a bad odor.
• Drainage from the bulb increases for more than 2 days in a row.
• The squeeze bulb will not stay collapsed.
• The drainage stops suddenly when the drain has been steadily putting out fluid.

Bulb drain; Jackson-Pratt drain; JP drain; Blake drain; Wound drain; Surgical drain

Boukovalas S, Aliano KA, Phillips LG, Norbury WB. Wound healing. In: Townsend CM Jr, Beauchamp RD, Evers M, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier, 2022:chap 6.

Updated by: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.