An interventional study of Purse string suture closure and Plug method closure in Pneumothorax, Hemothorax and Chest Tube, sponsored by Pakistan Institute of Medical Sciences. Not yet recruiting at 1 site in Pakistan. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-01-06.
Sponsored by Pakistan Institute of Medical Sciences · Not applicable, Interventional, and Treatment
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.
183 studies on the registry are indexed under Pneumothorax; 41 are open to participants now.
This study's planned enrollment of 246 is above the median of 100 across 111 interventional studies indexed under Pneumothorax.
Browse Pneumothorax studies →Pakistan Institute of Medical Sciences is the lead sponsor of 55 studies on the registry; 25 are open to participants now.
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Exclusion criteria:
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
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
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.
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.
"Incidence of air leak after chest tube removal using purse-string suture or plug method"
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.
Time frame: 48 hours
Incidence of wound infection after chest tube site closure using purse-string suture or plug method
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
Time frame: 7 Days
Scar appearance score at chest tube site measured using the Vancouver Scar Scale
Scar quality at the chest tube removal site assessed using the Vancouver Scar Scale, which evaluates pigmentation, vascularity, pliability, and height
Time frame: 1 month
Patient-reported cosmetic satisfaction score after chest tube site closure measured using a Numerical Rating Scale
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.
Time frame: 1 month
Plan to share: Yes — Age, comorbidity, condition, locality, registration number
No publications or documents are linked to this record.
Start is estimated for Jan 2026; primary completion for Dec 2026, 11 months later.
Of 42 interventional studies with no phase under Pneumothorax, half reached primary completion within 26 months of starting (the median), counting those still running; a quarter within 15 and three quarters within 34. This study's planned 11 months is below that.
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This study is not yet recruiting, as verified in Dec 2025. You cannot join it, but the record below documents what was studied.
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Pakistan Institute of Medical Sciences