Drains are used to remove and/or prevent fluid accumulation in dead space. When there is space between tissue layers, the body naturally wants to fill that space with fluid which will physically prevent the tissue layers from adhering to one another and healing.
Drains should be used whenever there is space found between layers in a wound. Also consider using a drain if you are closing a wound that is in a high motion area like a joint or in the axilla or inguinal areas. The motion will cause the tissue planes to move against one another, producing fluid. If the wound is contaminated then a drain should definitely be placed after the wound has been properly lavaged.
Finally, when in doubt, just place a drain. You can always remove it in 24hrs if you find it was not necessary. The best time to remove a drain is after the discharge has significantly reduced in volume. Do not expect it to go nothing. On average a drain is in place for 3-5 days.
The 2 main drain categories are (1) Passive or gravity drains such as a Penrose and (2) active or vacuum drains such as the Jackson Pratt drain.
