To Drain Or Not To Drain: That Is The Question For The Pilonidal Surgeon
At PTCNJ, the drain used in the cleft-lift procedure is called a Blake drain. It is a closed-suction device used to evacuate clear fluid called serum, which tends to be produced under a closed surgical wound. The drain is made of soft flexible plastic-like material. It consists of a thin tube, part underneath the skin and part outside of the skin, connected to a grenade-shaped bulb which can be tucked into the underwear. Several times per day, the bulb is emptied, compressed, and clamped. By virtue of its elastic material, it slowly self-expands, and in the process of expansion, it suctions out the serum. At PTCNJ, a drain usually stays in for one week after a cleft-lift or simple pilonidal cystectomy.
Is a drain really necessary with a cleft-lift procedure? This is a question often asked by prospective patients. The answer is yes. Drainage prevents a recognized cause of postoperative wound failure, specifically a buildup of serum under the closure known as “seroma”. With a sound cleft-lift, a majority of patients would still probably heal without drain placement, but a subset would not. Preoperatively, it is impossible to reliably determine into which group a patient will fall. Accordingly at PTCNJ, we uniformly drain all cleft-lifts to maintain the 98% early healing rate now widely reported.