Jackson-Pratt (JP) Drain
The Jackson-Pratt (JP) drain is the most commonly used closed-suction wound drain in reconstructive urology. A soft silicone tube connects to a bulb reservoir that generates negative pressure when compressed and released.
Design
- Flat silicone catheter (perforated fenestrations) or round catheter (perforated side holes along the distal length)
- 7 mm flat bulb or 10 mm round typical adult sizes
- Bulb reservoir (~100 mL capacity) — squeezed empty then closed to create constant low-level suction
- Radiopaque marker strip for imaging
Use in Reconstructive Urology
- Post-cystectomy / urinary diversion — pelvic drainage to monitor for urine leak
- Post-prostatectomy — pelvic drain, typically removed POD 1–2
- Post-ureteral reconstruction — retroperitoneal drain near the anastomosis
- Post-VVF / rectourethral fistula repair — pelvic drain with vigilance for urine drainage
- After radical nephrectomy / partial nephrectomy — perinephric drainage
- Post-phalloplasty — donor-site and recipient-site drainage
- Post-scrotal / perineal reconstruction — dead-space evacuation
Placement
- Exit through a separate stab incision, away from the main wound
- Secured to the skin with a suture
- Positioned in the lowest dependent part of the operative bed
Management
- Drain output — recorded q8h; declining output suggests readiness for removal
- Drain creatinine — if urine leak is suspected, send drain fluid for creatinine; drain creatinine >> serum creatinine = urinary fistula
- Removal criteria: typically <30 mL / 24h, non-serous, no bilious or purulent appearance
- Culture the drain if output becomes purulent or SIRS develops
Complications
- Infection — drain tract cellulitis, retained drain fragments
- Retained drain — if the drain breaks during removal, imaging and occasional operative retrieval required
- Skin breakdown around exit site
- Drain injury to adjacent structures — ureter, bowel — rare but documented
See also: Blake Drain, Penrose Drain.