PneumothoraxNCT07319572
Comparison of Chest Tube Wound Closure: Comparison Between Purse String Method and Plug Method.
A study testing Purse string suture closure and Plug method closure in people with Pneumothorax and Hemothorax, run by Pakistan Institute of Medical Sciences at 1 site in Pakistan.
Trial summary
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. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Pneumothorax, Hemothorax, Chest Tube
- What is being tested?
- Purse string suture closure and Plug method closure
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 246 participants
- Where
- 1 sitePakistan
- Study dates
- 1 Jan 2026to 31 Dec 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- All patients >18 years of age
- Patients undergoing chest tube insertion for traumatic causes including Pneumothorax, hemothorax and hemopneumothorax.
Who cannot join
- Previous ipsilateral thoracic surgery
- Patients with large wounds necessitating suture closure
- Patients with bleeding disorders
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
About this study
Official title: 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.
Read the 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.
- Conditions
- Pneumothorax, Hemothorax, Chest Tube, Chest Tube Removal, Purse String, Plug Method
- Being tested
- Purse string suture closure, Plug method closure
- Keywords
- Purse-string, Plug method, Chest tube, Pneumothorax, hemothorax
- Medical subject headings
- Pneumothorax, Hemothorax
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Purse string suture closureProcedure or surgery
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 closureProcedure or surgery
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.
| Study group | Role | What they receive |
|---|---|---|
| Purse string group | Active comparator | 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. Receives: Procedure: Purse string suture closure |
| Plug Method group | Experimental | 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 Receives: Procedure: Plug method closure |
What is being measured
The primary outcome is the main question the study is designed to answer.
"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.
Measured: 48 hours
Secondary outcomes (3)
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
Measured: 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
Measured: 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.
Measured: 1 month
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Jan 2026
- Study start1 Jan 2026 (estimated)
- Primary completion31 Dec 2026 (estimated)
- Study completion31 Dec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for PneumothoraxStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 246 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Pakistan Institute of Medical Sciences
- Sponsor type
- Other government
- Responsible party
- Principal investigator, Muhammad Fahad Ali, Pakistan Institute of Medical Sciences
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07319572
- Sponsor's protocol ID
- F-5-2/2024(ERCC)/PIMS
- Status last verified
- Dec 2025
- First submitted
- 7 Dec 2025
- Last updated
- 6 Jan 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Age, comorbidity, condition, locality, registration number
Study at a glance
From the registry record, last updated by the sponsor on 6 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Optimizing Chest Tube Removal: A Comparison of Purse-string Suture Closure and Plug Method.
- ClinicalTrials.gov ID
- NCT07319572
- Acronym / sponsor ID
- F-5-2/2024(ERCC)/PIMS
- Conditions
- Pneumothorax, Hemothorax, Chest Tube, Chest Tube Removal, Purse String, Plug Method
- Keywords
- Purse-string, Plug method, Chest tube, Pneumothorax, hemothorax
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 246 participants (estimated)
- Lead sponsor
- Pakistan Institute of Medical SciencesOther government
- Study start
- 1 Jan 2026 (estimated)
- Primary completion
- 31 Dec 2026 (estimated)
- Study completion
- 31 Dec 2026 (estimated)
- First posted
- 6 Jan 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
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 design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Purse string group | Active comparator | Procedure: Purse string suture closurePatients 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. |
| Plug Method group | Experimental | Procedure: Plug method closureAfter 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 |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- All patients >18 years of age
- Patients undergoing chest tube insertion for traumatic causes including Pneumothorax, hemothorax and hemopneumothorax.
Key exclusion criteria (3 listed)
- Previous ipsilateral thoracic surgery
- Patients with large wounds necessitating suture closure
- Patients with bleeding disorders
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Purse string suture closurePURSE 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. | Procedure or surgery | Purse string group |
| Plug method closureAn 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. | Procedure or surgery | Plug Method group |
Primary outcome
"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.
3 secondary outcomes
Incidence of wound infection after chest tube site closure using purse-string suture or plug method
Time frame: 7 Days
Scar appearance score at chest tube site measured using the Vancouver Scar Scale
Time frame: 1 month
Patient-reported cosmetic satisfaction score after chest tube site closure measured using a Numerical Rating Scale
Time frame: 1 month
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 Jan 2026.
- Individual participant dataSharing planned: Yes. Age, comorbidity, condition, locality, registration number
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Purse string suture closure and Plug method closure in people with Pneumothorax and Hemothorax, run by Pakistan Institute of Medical Sciences at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 6 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Muhammad Fahad Ali Ali, MBBS (+923320601136, joyafahad@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
"Incidence of air leak after chest tube removal using purse-string suture or plug method" (time frame: 48 hours). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Jan 2026.