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

December 19, 2025 updated by: Muhammad Fahad Ali, Pakistan Institute of Medical Sciences

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.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

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.

Study Type

Interventional

Enrollment (Estimated)

246

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Pakistan
    • Islamabad
      • Islamabad, Islamabad, Pakistan
        • Pakistan Institute of Medical Sciences

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: 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.
Procedure: 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.
Experimental: 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
Procedure: 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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
"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.
48 hours

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
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
7 Days
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
1 month
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.
1 month

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Pakistan Institute of Medical Sciences

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

January 1, 2026

Primary Completion (Estimated)

December 31, 2026

Study Completion (Estimated)

December 31, 2026

Study Registration Dates

First Submitted

December 7, 2025

First Submitted That Met QC Criteria

December 19, 2025

First Posted (Actual)

January 6, 2026

Study Record Updates

Last Update Posted (Actual)

January 6, 2026

Last Update Submitted That Met QC Criteria

December 19, 2025

Last Verified

December 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • F-5-2/2024(ERCC)/PIMS

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Age, comorbidity, condition, locality, registration number

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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