A novel technique for chest drain removal using a two layer method with triclosan-coated sutures

Abstract

In thoracic surgery, a thoracic drain is always inserted after the surgical procedure. Repair of the wound after removal of the thoracic tube is performed postoperatively, but no universally standard methods currently exists for this tube removal. Here we report a technique using triclosan-coated sutures that is used in thoracic surgery in our hospital. There are several advantages of this technique. First, there is no need for stitches removal on follow-up. Second, it prevents the leakage of pleural exudate because of the tight two-layer sutures. In addition, it was observed to be superior in terms of both wound healing and cosmetic aspects, due to the layer-to-layer sutures. The use of triclosan-coated sutures helps prevent infection and empyema is quite unlikely to occur as the result of the tight ligating of the muscular layer using these sutures. We applied this method in 168 patients over a period of 24 months. There were no complications on removal of the chest tube such as infection, fluid leakage or opening of the surgical wound.

Keywords: New method; thoracic drain; triclosan-coated suture; wound infection.

Figure 1

Step-by-step explanatory diagram of suture method. (A) Muscular-layer-suture at one side; (B) the other side of the muscular-layer suture; (C,D) U-shaped suture on muscular layer; (E-H) figure-eight shaped dermostitches; (I) just before the insertion of the chest tube; (J) attachment of the threads to the tube.

Figure 2

Actual photo immediately after the removal of the chest tube.