Ortho uses a LOT of both of these!

JP: The JP is a bulb with a length of perforated tubing. The “holes” are all beneath the surface in order to remove the drainage and maintain suction. We emptied the JP 3x day (usually no more than a few cc so we used a med cup to measure).

The length of the incision will closely approximate the length of the tubing under the surface. Release the suction by opening the drain plug. Then in one smooth movement after VISUALLY identifying the insertion site, pull the JP tubing out.

It SHOULD slip out about as easily as a foley or an NG tube. If the skin dimples or you have difficulty STOP! There is a problem, either a stitch or a clot is holding it in. CALLTHE DOC. They CAN and DO break off!

There’s a technique in the Blue Ortho journal that addresses this in case the DOC doesn’t know how either.

Retention sutures: They can be wire with rubber tubing to keep from cutting into the skin…I leave those to the doctor.

If they are polymer or plain old silk, it is just like removing regular sutures. Clip close to the skin and pull out from the other insertion point.

If they are the John Charnely “marshmallow pillow” sutures, you clip close to the skin near one pillow and pull the other one out.

And YES a patient should have the right to refuse treatment, and to have someone who has experience. Your agency could probably get a surgeon to stitch a piece of chamois or leather to illustrate. Nothing to it once you know how.