Suction drains play a critical role in postoperative care, effectively removing fluid from subcutaneous, intraabdominal, retroperitoneal, and other surgical spaces, as well as from abscesses and hematomas. They aid in monitoring for complications such as bleeding and leakage and are commonly placed when fluid accumulation or dead space formation is anticipated, particularly after extensive dissection. By promoting efficient fluid drainage, suction drains help maintain proper tissue plane contact, which is essential for optimal healing, especially in grafting and reconstruction procedures. Their use enhances surgical outcomes by reducing the risk of complications and supporting tissue integration. Specifically, suction drains reduce the risk of postoperative fistulas, particularly in pancreatic or biliary resections and reconstructions.

Suction drains are classified as closed or open systems, with the type selected based on the clinical scenario and clinician preference. Closed systems consist of an outflow conduit and a collection chamber and may rely on gravity or negative pressure to facilitate drainage. Open systems, on the other hand, allow fluid to flow freely from the wound to the external environment. Examples of closed suction drains include the pigtail, Jackson-Pratt, and Blake drains and active negative-pressure systems such as wound vacuums, which can operate continuously or intermittently. An open drain, such as the Penrose, uses capillary action and gravity for fluid removal and is typically used in more superficial spaces. While negative-pressure systems are often more effective at draining fluid, passive drains are preferable in specific clinical situations, such as near new anastomoses, where aggressive drainage may promote fistula formation or delay healing.

Most drains allow for management in-hospital and at home or rehab centers. Placement of drains has become routine following surgery involving extensive dissection or reconstruction. Still, study results have indicated that empiric drain placement may not decrease adverse events and may increase costs and complications related to drains. The data regarding prophylactic drainage following major surgeries are equivocal, and results from several studies point to the lack of improved outcomes with empiric drain placement. Additionally, drains may inoculate a wound with pathogens or cause injury during placement. The drain apparatus may become displaced or broken through pulling and inadvertent trauma and require repositioning or replacement.