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

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

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.

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.

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