Wednesday, April 26, 2006

Draining

What's this draining Venita and Jim always are talking about?

Best we understand is that a part of healing a wound like V's mastectomy wound is the adhesion of the back side of the skin layer to the underlying tissue (given the mastectomy removed the intervening breast tissue). This wound is like a giant blister in that fluid builds up between the skin layer and the underlying tissue. As the wound heals, the volume of the fluid diminishes and the "seal" occurs.

During surgery, the surgeon inserts one or more drains to draw off the excess fluid and encourage the healing process. V had a drain in for four weeks; the volume of the fluid draw-off barely reduced during that month(~150 ccs--or 2/3 cups--a day). The theory was to pull the drain and "force" the tissue to start reabsorbing the fluid. That is working in part. Every Monday and Thursday V returns to Dr. Boob to have the excess fluid drained off.

How does this draining happen? Dr. Boob cuts a small hole in V's skin below the mast scar. He takes a blunt-ended needle (10 gauge or larger we would guess) and pushes it through the hole and some interior tissue until he gets to the fluid pocket. He then screws on a 60cc syringe and slowly draws up the fluid. Unscrew the syringe, dump the fluid, screw the syringe back on, and repeat until--like a straw in a juice box--all Dr. Boob does is draw air and the tissue pulls taut. Dr. Boob routinely gets 300 ccs--1 1/3 cups.

When might this end? Soon we hope. There's alot of pressure with the fluid build-up, and V doesn't like feeling like a juice box 2x/week.

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