Author

Stephen J. Birchard DVM, MS, Diplomate ACVS

Saturday, March 15, 2014

Jackson Pratt Drains for Wounds in Dog and Cats: So much better than the Penrose!

Penrose drains are so last century. 
Does this look like effective wound
drainage in this dog?
Penrose drains are considered “open” drains, which means they establish an open pathway from the wound to the outside. They require bandaging to protect the drain and collect the drainage fluid, and they allow ascending infection by wicking bacteria into the wound. Pen rose tubing is soft and collapsible. Drainage occurs mostly via the outside of the tubing material and is prone to obstruction when the fluid is thick and viscous.

Closed suction drains, such as the Jackson Pratt (J-P), are a more effective method of wound drainage. 
Jackson Pratt closed suction drain
Negative pressure generated by the drain reservoir (also called the “grenade”) pulls fluid out of the wound rather than relying on passive drainage. The J-P tubing exits a location distant from the wound and is secured with a purse string and Chinese finger trap suture, preventing ascending bacterial contamination.

The J-P drain is composed of a soft, white, silicone drain tube that is implanted into the wound. This is connected to clear tubing that exits the wound and terminates in the reservoir.  There are multiple sizes of tubing and reservoirs. Negative pressure is generated by closing the reservoir cap while compressing it. Emptying the reservoir is simply done by opening the cap and pouring the fluid out. It does not have to be disconnected from the tubing to be emptied. 
  
Implantation of a JP drain after removal of a large lipoma
in a dog.

Same dog as above with J-P in place and secured with suture.
The grenade has been compressed and the cap closed and fluid
is being suctioned from the interior of the wound.
Closed suction drains are indicated in wounds that are being closed but have large areas of dead space that can fill with fluid. The only bandaging necessary in most patients is some stockinet or other light bandage material used to stablilize the reservoir. The drain is well tolerated by animals and they can even be sent home and owners taught how to drain the grenade. 
Large cervical bite wound in a pit bull dog.
Initial therapy was with tie-over bandages.
After several days of open wound management,
closure was performed over a JP drain.
Another advantage of the Jackson Pratt is that the amount of fluid being produced by the wound can be quantified. This is especially helpful when used for generalized peritonitis in dogs or cats. (1) (See blog from 11/21/13 on treatment of intestinal dehiscence).

J-P drains are more expensive than pen rose drains but I think their effectiveness justifies the cost.  They are available through amazon.com for about $9 per unit. That’s a pretty small price to pay for such a versatile and effective drainage apparatus.

References

1. Mueller MG1, Ludwig LL, Barton LJ. Use of closed-suction drains to treat generalized peritonitis in dogs and cats: 40 cases (1997-1999). J Am Vet Med Assoc. 2001 Sep 15;219(6):789-94.