Comparison of Chest Tube Wound Closure: Comparison Between Purse String Method and Plug Method.

Официальное название

Optimizing Chest Tube Removal: A Comparison of Purse-string Suture Closure and Plug Method.

Обзор

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.

Подробное описание

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.

Вмешательства

• Процедура Purse 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.
• Процедура Plug 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.

Первичные конечные точки

• "Incidence of air leak after chest tube removal using purse-string suture or plug method" [Срок оценки: 48 hours]

Вторичные конечные точки (3)

• Incidence of wound infection after chest tube site closure using purse-string suture or plug method [Срок оценки: 7 Days]
• Scar appearance score at chest tube site measured using the Vancouver Scar Scale [Срок оценки: 1 month]
• Patient-reported cosmetic satisfaction score after chest tube site closure measured using a Numerical Rating Scale [Срок оценки: 1 month]

Критерии участия

Критерии включения

• All patients >18 years of age
• Patients undergoing chest tube insertion for traumatic causes including Pneumothorax, hemothorax and hemopneumothorax.

Критерии исключения

• Previous ipsilateral thoracic surgery
• Patients with large wounds necessitating suture closure
• Patients with bleeding disorders

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Нерандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Лечение

Центры проведения

Пакистан · 1 центр

• Pakistan Institute of medical sciences — Islamabad

Идентификаторы

NCT: NCT07319572 · F-5-2/2024(ERCC)/PIMS

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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