Knotless suture and hydrocolloid method improves chest drain wound complication

Ligation is a widely used wound closure method after chest drain removal in thoracic surgery. Knotless suture, which does not require ligation or suture removal, has been developed and is currently used in our institution. This study compared the efficacy of the drain wound closure method between knotless suture and our previous mattress suture.

We examined the clinical performance of knotless suture for chest drain wound closure in 117 patients who underwent surgery following this method in our department from October 2020 to April 2021. We compared outcomes with those of mattress suture using 2-0 nylon in 115 patients who underwent thoracic surgery at our institution between October 2018 and April 2019. Hydrocolloid dressing is applied to the drain wound after chest drain removal in a knotless suture. We conducted an analysis of both groups based on the condition of wound closure and drain wound complication.

Appropriate wound closure was obtained and no patient required a prolonged hospital stay because of incomplete wound closure in both methods. The rate of chest drain wound infection for knotless suture (0.0%, 0/117 patient) was significantly lower than that of mattress suture (5.2%, 6/115 patients) at the outpatient follow-up (p = 0.01). The rate of delayed drain wound healing was also significantly lower than that of mattress suture (0.9% vs. 7.0%; p = 0.02).

The results of knotless closure were better than those of conventional mattress suture regarding wound complications. Moreover, knotless suturing requires no suture removal, indicating its usefulness.