Optimizing Chest Tube Removal: A Comparison of Purse-string Suture Closure and Plug Method.
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 246
- 试验地点
- 1
- 主要终点
- "Incidence of air leak after chest tube removal using purse-string suture or plug method"
研究概览
简要总结
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.
详细描述
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •All patients >18 years of age
- •Patients undergoing chest tube insertion for traumatic causes including Pneumothorax, hemothorax and hemopneumothorax.
排除标准
- •Previous ipsilateral thoracic surgery
- •Patients with large wounds necessitating suture closure
- •Patients with bleeding disorders
研究组 & 干预措施
Purse string group
Patients in this arm will have the chest tube removal site closed using a purse-string suture technique. After chest tube removal and haemostasis, a single circumferential (purse-string) stitch is placed around the wound margin and tightened to approximate the skin edges. Skin is left approximated; additional superficial interrupted skin sutures may be applied at the investigator's discretion. Suture material: monofilament nylon or silk, per local practice. Standard sterile dressing applied. Post-procedure wound care and follow-up are identical to the comparator arm.
干预措施: Purse string suture closure (Procedure)
Plug Method group
After chest tube removal, the wound is swiftly plugged off with an impregnable gauze and no sutures applied. The gauze is then fixed with air tight dressing
干预措施: Plug method closure (Procedure)
结局指标
主要结局
"Incidence of air leak after chest tube removal using purse-string suture or plug method"
时间窗: 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.
次要结局
- Incidence of wound infection after chest tube site closure using purse-string suture or plug method(7 Days)
- Scar appearance score at chest tube site measured using the Vancouver Scar Scale(1 month)
- Patient-reported cosmetic satisfaction score after chest tube site closure measured using a Numerical Rating Scale(1 month)
研究者
Muhammad Fahad Ali
Principal Investigator (General Surgery Resident)
Pakistan Institute of Medical Sciences