Types of Drain

Drains can be divided into passive and active drains.

Passive Drains

Passive drains, such as the Penrose (A-1) and Easy Flow (A-2) devices, serve to evacuate fluid passively by providing a route of access secondary to the natural pressure gradients, such as gravity flow, muscle contraction, and overflow. The opening in the abdominal wall for these drains should be made large enough, because passive drains are potentially collapsible. Easy Flow drains have intraluminal corrugations to prevent complete collapse (inlay). Passive drains cannot be sealed and are open systems with the potential risk of retrograde infections. The advantages and disadvantages of open and closed-suction drains are outlined in Table 1.

Jackson Pratt

Aktive Drains

Jackson-Pratt (A-1) and Blake (A-2) drains are commonly used radiopaque, silicone products for closed-suction systems. The Jackson-Pratt drain is oval-shaped with numerous orifices and intraluminal corrugations (inlay). The Blake drain has four channels along the sides with a solid core center. In contrast to passive drains, active or suction drains maintain a negative pressure gradient.

Blake Drain

Sump Drains

Sump drains are usually double-lumen tubes with a larger outflow lumen and a smaller inflow "sump" lumen. The larger lumen is connected to a suction system and evacuates intra-abdominal secretions. The smaller lumen serves as a venting tube, allowing air to enter the larger lumen. This principle should help to break the vacuum in the large draining tube, maintaining the drain in a productive state, without the surrounding tissues continually occluding the drainage holes in the tube. Sump drains are often used when large fluid volumes have to be evacuated. The occlusion of the smaller venting tube by tissue debris due to retrograde inflow demonstrates a potential disadvantage of sump drains that occurs especially when the suction is disconnected. Some sump drains have an additional third lumen that allows the instillation of an irrigating solution.

Closed Suction Penrose Drain

Complete Drainage System

Collapsible devices connected to the drain tubes automatically generate a negative pressure gradient and keep the system "sealed," which is believed to result in a significant reduction of retrograde infections.

Table 1. Advantages and disadvantages of open and closed-suction drains

Open drain

Closed-suction drain


Generates pathways for bulky or viscous material

Lowers risk of retrograde infection

Lowers risk of mechanical

Accurate measurement of drainage

erosion and pressure necrosis

Facilitates radiographic studies

Skin protection from irritating discharge


Retrograde infection

More vulnerable to obstruction by small tissue fragments or ingrowth of surrounding tissue

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