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NCT Number: NCT07319572

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

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Key information

Conditions

Pneumothorax Chest Tube Chest Tube Removal Hemorrhage Hemothorax Pathologic Processes Pathological Conditions, Signs and Symptoms Pleural Diseases Plug Method Purse String Respiratory Tract Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Pakistan Institute of medical sciences

Islamabad, Pakistan

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

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

Exclusion criteria

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

Treatment and study plan

Purse string suture closure

Procedure

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.

Plug method closure

Procedure

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.

Primary outcomes

  1. "Incidence of air leak after chest tube removal using purse-string suture or plug method"

    Time frame: 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 outcomes

  1. Incidence of wound infection after chest tube site closure using purse-string suture or plug method

    Time frame: 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

  2. Scar appearance score at chest tube site measured using the Vancouver Scar Scale

    Time frame: 1 month

    Scar quality at the chest tube removal site assessed using the Vancouver Scar Scale, which evaluates pigmentation, vascularity, pliability, and height

  3. Patient-reported cosmetic satisfaction score after chest tube site closure measured using a Numerical Rating Scale

    Time frame: 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.

Study contacts

Contact information is provided by the study sponsor or research team.

Muhammad Fahad Ali Ali, MBBS

CONTACT

[email protected]

+923320601136

Sponsors and collaborators

Lead sponsor

Pakistan Institute of Medical Sciences

Other Gov

Registry information

Official study title

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

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Jan 6, 2026
Registry last updated
Jan 6, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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