How to Care for a Pigtail Drain

What is a pigtail drain?

A drain is a small tube that lets unwanted fluid out of the body. A pigtail drain is a type of drain used to let fluid out of the area around the lungs or abdomen.  

A special doctor, called a radiologist or surgeon, will put a drain in if your child needs it. If the drain is placed outside surgery, they numb the area where the drain is placed. The procedure usually does not hurt. If the drain is placed during surgery, your child will be under anesthesia. 

Your child’s pigtail drain is 1 of the types below. Which type depends on where it is. Your child might have: 

• Pleural drain – Used in the lung area 
• Peritoneal drain – Used in the belly abdomen 
• Nephrostomy tube – Used in the kidney 

If your child has a pigtail drain, you will need to take care of it when you are not in the hospital. You can take care of it by flushing it and changing the dressing. It is important to flush the drain at least once a day. This prevents clots and helps the fluid drain easily.  

Change the dressing: 

• As often as your care team tells you to change it 
• Any time it is wet, loose, or dirty 

How to flush a pigtail drain

Supplies needed

• Saline flush  
• Red cap 
• Alcohol pads or Site Scrubs® 

Preparing for the flush

• Clean your work area with an alcohol pad or other disinfectant.  
• Clean your hands with soap and water and dry them well. Or use an alcohol-based liquid or foam hand cleaner.  
• Gather your supplies and place them on the clean work area.  
• Open each package but leave the items inside until you are ready to use them. This helps make sure the items stay sterile (free of germs).

Flush the drain 

• Turn the tap so the word “OFF” points to your child. This keeps body fluid from leaking into the tube.  
• Clean the flush port with an alcohol pad and let it dry by itself. Do not blow on it or fan it.  
• Attach the saline flush. 
• Open the tap so the open side is toward your child. The word “OFF” points to the bag.  
• Gently flush the tube with 3 ml of saline. Do not force the flush. 
• Turn the tap so the word “OFF” points to your child. Gently flush the tube with 3 ml of saline.  
• Turn the tap so the open side points to the flushing port. This lets fluid drain from your child’s body into the bag. Remove the syringe.  
• Clean the flush port with a new alcohol pad. 
• Put the new red cap on the port. 
• Clean your hands again. 

How to change the dressing

Supplies needed

• Dressing kit with ChloraPrep™ (Do not use if your child is younger than 2 months old.)   
  • A package of povidone-iodine swabs – If your child is allergic to the ingredients in ChloraPrep or younger than 2 months old. 
• Saline flush  
• 2 sterile wipes 
• 1 sponge with chlorhexidine in it 
  • You may use sterile antimicrobial split gauze if your child is allergic to chlorhexidine or younger than 2 months old. 
• 1 piece of no-sting barrier film 
• Non-sterile gloves 
• Clear dressing 
• One sterile gauze pad, 3 by 3 inches square 
• Hypafix® 
• Adhesive remover pads, such as Remove™ 
• A fastener to keep the drain in place, such as StayFixÒ or StatLockÒ 
• Alcohol pads 

Preparing for the dressing change

• Clean your work area with an alcohol pad or other disinfectant. 
• Clean your hands with soap and water and dry them well. Or use an alcohol-based liquid or foam hand cleaner. 
• Gather your supplies and place them on the clean work area. 
• Open each package but leave the items inside until you are ready to use them. This helps make sure the items stay free of germs. 

1. Remove the old dressing 

• Put on non-sterile gloves and use wipes to take off the old dressing.  
• Throw all the parts of the old dressing into the trash. Do not let them touch your clean work surface. 
• Use sterile wipes to clean off any stickiness from the dressing. Dry the area with sterile gauze. 
• If your child has these, take off the fastener that keeps the drain in place or the sponge with chlorhexidine in it. 
• Use a wipe to take off any more adhesive. Be careful not to touch the area where the drain goes into the body. 
• Check this area for redness, swelling, or fluid. 
• Take off your gloves and wash your hands. 

2. Clean the drain area 

• Open the dressing kit and drop your supplies onto your clean work area. 
• Put on sterile gloves. 
• Use ChloraPrep to clean your child’s skin and the first 2 inches of the catheter: 
  • Dab the area where the drain goes into the body 3 times with the ChloraPrep. 
  • Clean around this area. Use an up and down, then side to side motion. Go 3 inches past the area where the drain goes into the body. Clean for 30 seconds. 
  • Let the area dry. Do not blow on it or fan it. 
  • If you are using povidone-iodine swabs, follow the steps below. 
    • Start cleaning at the spot where the drain goes into the body. Dab in a spiral out toward the rest of the body. This helps keep skin bacteria from getting into the area where the drain goes in. Clean an area of about 3 inches around where the drain goes in. 
    • Throw away the first swab. Repeat the process with the next 2 swabs. 
    • Let the area dry. Do not blow on it or fan it. 
  • Clean the catheter with alcohol pads.  
  • Take off any sticky material left by the tape. 

3. Put on the new dressing 

• Put on the dressing and fastener. 
• Put no-sting barrier film where you will put the new dressing. 
• Cover the film with the clear dressing. This keeps the drain in place. 
• Use Hypafix to hold the edges of the clear dressing in place. You may use a sterile gauze pad if your child has skin problems or liquid is coming from the area where the drain enters the body. 
• Take off your sterile gloves. Clean your hands again. 
• Put the label from the dressing kit on the dressing. Write your initials and the date and time you changed the dressing on the label. 

Recording output 

• After flushing the drain, empty the drainage bag into the container the nurse gave you.  
• Measure the amount of liquid in the container. Then, subtract the amount of the daily flush. The amount you have left is called the “output amount.” It is how much fluid the drain is letting out of your child’s body. 
• Also, write down what color the fluid was. Bring your records to your child’s appointment. The records help the care team check how well the drain is working. 

When to call for help 

Call the care team if your child has a fever or you notice any signs of infection in the area around the drain. Signs of infection include: 

• Redness 
• Swelling 
• Heat 
• Pain in the area 
• Fluid or pus coming from around the drain 

Do not let the drain go under water. 

If the drain comes out, cover the area with sterile gauze. Do not try to put the drain back in. Call your child’s care team. 

Also, call your child’s care team if any of the following things happen: 

• Your child has sharp, severe pain. 
• The tube stops draining. 
• You cannot flush the drain. 
• The fluid that drains is bloody or a different color from normal. 
• You notice a lot of material in the fluid, or the fluid smells bad.