A rare case of a blood clot masquerading as a retained surgical drain

Abstract

Surgical drains are commonly used in surgery to reduce post-operative fluid collections. Whilst rare, a retained surgical drain may result in clinical complications and distress to the patient. A retained surgical drain is a potentially avoidable event and surgeons should be aware on how to confirm the presence of a retained surgical drain. We report a rare case of a blood clot masquerading as a retained surgical drain in a patient. The patient is a 55-year-old Malay male who presented with left gluteal necrotizing fasciitis. The patient underwent a further 5 debridements with subsequent closure of the wound. Two drains were inserted on closure. Whilst there was no difficulty in removal of the drain, post removal magnetic resonance imaging revealed a tubular structure in the left gluteal region, thought to be a retained drain segment. Intra-operatively, the drain segment seen on magnetic resonance imaging (MRI) was not found and instead, a tubular blood clot of similar caliber and length as measured on the MRI was found residing in the gluteal region. This case highlights the need for confirmation of a retained drain segment before surgical removal. Surgeons should be certain of the presence of a retained surgical drain before advocating for surgical removal. Plain radiography remains a useful modality for visualization of radioopaque surgical drains.

Implementing Nursing round to Deal with Unresolved Nursing Problem on Patient with Acute Pain: A Case Report

“…Surgical drainage is an important routine operation in surgery to drain fluid out of the body and reduce post-operative fluid collections. 17 , 18 Inadequate surgical drainage treatment leading to blockage may result infection, worsening inflammation, slow wound formation, and increase complication. 19 Therefore, if it is noticed that there is no fluid in the bulb, check the tubing for a possible blockage caused by a clot and then evacuate them.…”

Analysis of the Emergency Nursing Staff Need Using Baseline Emergency Staffing Tool (Best) In Indonesia: A Prospective Study

“…It may lead to nurse fatigue, decreased attention to patient needs, and decreased overall quality of care (Griffiths et al, 2016). It also poses potential risks, such as nurse burnout, compromised patient safety, and diminished quality of care (Ho & Chua, 2016). The difference between the required and scheduled staff highlights the need for a more accurate estimation of staffing needs (Davis et al, 2014).…”

A forgotten retained drain inside a knee for 10 years: A case report

“…Confirmation techniques include performing a plain radiograph as silicone drains are radiopaque and will be seen by the radiologist [ 5 ]. Furthermore, radiographs provide information on the exact location, which could be aided by magnetic resonance imaging to contribute extensive information about the presence of complications such as hematoma or articular cartilage damage [ 3 , 14 ].…”

“…Although there are no specific and scientific recommendations on when to remove a drain, it is generally extracted in the first few postoperative days. Removal is usually a simple procedure that is done at bedside via a simple pulling mechanism [ 3 ].…”

“…A retained and broken drain during removal is very rare, easily overlooked, and avoidable but can lead to serious complications and non-preferable sequences [ 3 , 4 ]. Moreover, lifting it inside the joint will increase the risk of neurovascular injury, irritating pain, and infection; another surgery with all of its complications may be necessary to remove it [ 1 , 2 , 5 ].…”