Vertical Lateral Suture Technique In The Closure Of Thoracic Drainage Tube Incision:A Randomized Controlled Trial

Objective: To explore the effect of new drainage tube hole suture and fixation on postoperative pain and scar formation,to design a safe,simple,economical,beautiful,and popularized method of drainage tube hole closure.Methods: A total of 104 inpatients were enrolled in the Department of Thoracic surgery of the first affiliated Hospital of Dalian Medical University from August to December2020.Those who met the enrollment criteria and obtained informed consent at 1:1 were randomly divided into the experimental group(n=52)and the control group(n=52).The traditional suture method was used in the control group.The clinical data were followed up during hospitalization and one month after the operation.The clinical data of patients in the test group and the control group were statistically analyzed,including sex,age,body mass index,hypertension,smoking,type of operation,suture time,drainage tube indwelling time,postoperative drainage hole related complications(incision dehiscence,incision hernia,incision infection,chest tube exfoliation,postoperative pneumothorax,subcutaneous emphysema),pain score during extubation and evaluation and rating of incision scar 1 month after the operation.Evaluate the feasibility and safety of the technology.Results: A total of 98 patients were enrolled in the study(6 patients lost follow-up),including 50 patients in the experimental group and 48 patients in the control group.there was no significant difference in sex,age,body mass index,hypertension,diabetes,smoking history,and other basic data between the two groups(P>0.05).There was no significant difference in albumin before the operation,white blood cell count,and neutrophil percentage the next morning after the operation(P>0.05).There was no significant difference in the choice of surgical methods(wedge resection,segmentectomy,lobectomy)and the number of incisions(two incisions,three incisions)between the two groups.Besides,there was no significant difference in the indwelling time of drainage tube,postoperative hospital stay,and the incidence of drainage tube related complications.among them,2 cases(4.0%)in the test group and 3 cases(6.3%)in the control group had poor wound dehiscence and poor healing after removal of the chest tube,which needed re-suture.There were 3 cases(6.0%)in the test group and 1 case(2.08%)in the control group after extubation,and all of them healed well after changing the dressing.Another4 cases(8.0%)in the intervention group and 2 case(4.2%)in the control group developed subcutaneous emphysema after surgery,which was also well absorbed by negative pressure suction and conservative observation.There were no incisional hernia,wound infection,accidental prolapse of the drainage tube,and pneumothorax after extubation in both groups.The data processing results showed that the time required to close the drainage tube incision in the test group was significantly longer than that in the control group(min)(8.94 ±4.22 vs 3.81 ±1.99,P<0.001),while the pain score during extubation in the test group was significantly better than that in the control group(mm)(18.84 ±15.12 vs 28.62 ±18.17).One month after the operation,the cosmetic effect of incision healing in the test group was better than that in the control group(4.08 ±2.16 vs 7.81 ±2.69 P<0.001).Conclusion: without increasing the complications related to the drainage hole,the vertical side suture method significantly reduces the pain during extubation,improves the appearance of the chest wall incision of the drainage tube,and has a good cosmetic effect,so it is a safe and feasible suture method.