Feasibility of an improved knotless method of chest drain wound closure: a prospective cohort clinical trial

Objective: Chest tube management plays a key role in minimising the perioperative period. We have improved the knotless method to close chest tube wounds. In this article, we demonstrate the clinical feasibility and safety of this method. Method: From 13 October 2018-3 January 2019, patients were consecutively included in our study at the First Affiliated Hospital of Dalian Medical University, Dalian, China. They were separated into two approximately equally sized groups-the knotless group and the conventional group. Our improved knotless method was performed to close the chest tube wounds of patients in the knotless group, and the conventional method using the pre-existing U-shaped string to close the chest tube wounds of patients in the conventional group. Patient clinical information, tube-related complications, retreatment times and cosmetic scores were compared between the groups. Results: The cohort comprised 102 patients; 47 in the knotless group and 55 in the conventional group. There were no statistically significant differences in patient clinical information or tube-related complications between the two groups (p>0.05; both comparisons). In the knotless group, retreatment times were shorter (p<0.001) and cosmetic scores were higher (p<0.001). Conclusion: This study showed that our new knotless method is safe and has wide clinical feasibility. The new method also improved patient cosmetic scores. Furthermore, it decreased the patients' economic burdens. Declaration of interest: This work was supported by grants from the National Natural Science Foundation of China (grant number 81774078, 81803886) and Natural Science Foundation of Liaoning Province, China (grant number 201602227, 20170540300). The authors have no conflicts of interest to declare.