Chest Tube, Chest Tube Removal, Hemothorax, Plug Method, Pneumothorax, Purse String
Conditions
Keywords
Purse-string, Plug method, Chest tube, Pneumothorax, hemothorax
Brief summary
This prospective, comparative clinical study evaluates two techniques of chest tube wound closure-purse-string suture and the simple suture/plug method-to determine differences in cosmetic outcomes, wound complications, and overall patient satisfaction following chest tube removal. The study aims to identify the closure technique that provides optimal wound healing with fewer postoperative complications.
Detailed description
Chest tube removal often results in small but cosmetically significant wounds. The traditional purse-string suture technique is widely used due to its presumed ability to ensure air-tight closure; however, it is frequently associated with circular or puckered scars that affect cosmetic appearance. Recently, the simple suture/plug method has been proposed as a more cosmetic alternative while maintaining adequate wound integrity. This study prospectively enrolls patients requiring chest tube removal and allocates them to one of the two wound closure techniques. Standardized postoperative care is provided to all participants. The primary outcome is cosmetic appearance of the scar, evaluated using a validated scar assessment scale at follow-up. Secondary outcomes include wound infection, seroma or discharge, persistent air leak, wound dehiscence, time to healing, and patient satisfaction. The findings are expected to help clinicians select the most effective and cosmetically favorable method for chest tube wound closure in routine surgical practice.
Interventions
PROCEDUREPurse string suture closure
PURSE STRING METHOD OF CLOSURE: A circumferential suture is placed around the chest tube insertion site before or after tube removal. The suture is tightened like a drawstring to approximate the skin edges and close the wound. This method provides an air-tight seal but often results in a puckered, circular scar. PLUG METHOD OF CLOSURE: After chest tube removal, the tract is allowed to collapse naturally and is gently plugged with a small gauze piece impregnated with petroleum jelly.
PROCEDUREPlug method closure
An impregnable gauze which is made airtight by coating it in petroleum jelly is swiftly placed over the chest wound site as the chest tube is removed and an air tight dressing done.
Sponsors
Pakistan Institute of Medical Sciences
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
: 1. All patients \>18 years of age 2. Patients undergoing chest tube insertion for traumatic causes including Pneumothorax, hemothorax and hemopneumothorax.
Exclusion criteria
1. Previous ipsilateral thoracic surgery 2. Patients with large wounds necessitating suture closure 3. Patients with bleeding disorders
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of air leak after chest tube removal using purse-string suture or plug method | 48 hours | It is the incidence of air leak/pneumothorax after the chest tube has been removed and the wound is closed by one of the two methods of chest tube wound closure; 1) the purse string method of chest tube wound closure and 2) the plug method of chest tube wound closure. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of wound infection after chest tube site closure using purse-string suture or plug method | 7 Days | Development of surgical site infection at the chest tube removal site after closure by purse-string suture or plug method, defined according to standard surgical site infection criteria |
| Scar appearance score at chest tube site measured using the Vancouver Scar Scale | 1 month | Scar quality at the chest tube removal site assessed using the Vancouver Scar Scale, which evaluates pigmentation, vascularity, pliability, and height |
| Patient-reported cosmetic satisfaction score after chest tube site closure measured using a Numerical Rating Scale | 1 month | Patient-reported cosmetic satisfaction with the chest tube removal site assessed using a Numerical Rating Scale, where: 0 = not satisfied at all 10 = completely satisfied Higher scores indicate better cosmetic satisfaction. |
Countries
Pakistan
Contacts
Primary ContactMuhammad Fahad Ali Ali, MBBS
Outcome results
None listed