Efficacy of Fixing Chest Tube to Chest Wall from Both Sides versus Single Side Fixation with Silk One Breaded Suture


  • Ahmed Raza Department of Surgery, Combined Military Hospital, Peshawar/National University of Medical Sciences (NUMS) Pakistan
  • Yasser Saeed Department of Surgery, Combined Military Hospital, Sialkot/National University of Medical Sciences (NUMS) Pakistan
  • Farhan Ahmed Majeed Department of Surgery, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Ahmed Waqas Department of General surgery, Northumbria Healthcare NHS Foundation Trust, United Kingdom
  • Imran Ashraf Department of General surgery, Combined Military Hospital, Khairan/National University of Medical Sciences (NUMS) Pakistan
  • Salahudin Masood, Mr Department of Public, Combined Military Hospital, Peshawar/National University of Medical Sciences (NUMS) Pakistan Health




Accidental dislodgement, chest intubation, fixity to chest wall, system leakage


Objective: To determine the efficacy of fixing chest tube to chest wall from both sides versus single side fixation with silk one

Study Design: Comparative cross sectional study.

Place and Duration of Study: Combined Military Hospital, Kharian Pakistan, from Mar 2021 to Jan 2022.

Methodology: Two hundered Patients undergoing chest intubation at CMH Kharian and referred from peripheral hospitals
were considered in the study and divided into two groups. In our setup (Group-A), chest tubes were fixed with a chest wall
with silk breaded sutures from both sides, compared to patients referred from peripheral hospitals (Group-B), who had chest
tubes fixed to the chest on a single side. They were analyzed for system leakage at the chest wall, to and fro movements of the
chest tube and accidental dislodgement.

Results: Unilateral chest intubation was done in 193(96.5%). Right sided intubations were 112(56%) and 81(40.5%) were left
sided. Most chest intubations done were either blunt or penetrating thoracic trauma 52(26%), early empyema thoracis 50(25%),
primary pneumothorax 30(15%), indeterminate pleural effusion 28(14%), secondary pneumothorax 24(12%) and malignant
pleural effusion 16(08%). System leakage was 2(02%) in group A to 13(13%).No chest tube was moved to and fro in Group-A
and 12(12%) in Group-B. In Group-A, accidental dislodgement was 3(03%), and 6(06%) patients had such complication in

Conclusion: Chest tube fixation with chest wall with silk one breaded suture gives better support to the chest tube from all
sides and minimizes the chances of system leakage, to-and-fro moveme




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Schein M. To drain or not to drain? The role of drainage in the

contaminated and infected abdomen: an international and

personal perspective. World J Surg 2008; 32(2): 312-321.


Liao CS, Shieh MC. Laparoscopic retrieval of retained

intraperitoneal drains in the immediate postoperative period. J

Chin Med Assoc 2011; 74(3): 138-139.


Rashid MA, Wikström T, Ortenwall P. A simple technique for

anchoring chest tubes. Eur Respir J 1998; 12(4): 958-959.


Hormbrey E, Pandya A, Humzah D. Drain fixation made

foolproof. Ann R Coll Surg Engl 2000; 82(4): 290-292.

Frank M. A simple technique for securing tubes. Ann Emerg

Med 1983; 12(1): 25-27.


Boyle A. Securing intercostal drains. J Accid Emerg Med 1999;

(3): 239. https://doi.org/10.1136/emj.16.3.239

Haas AR, Sterman DH. Advances in pleural disease

management including updated procedural coding. Chest 2014;

(2): 508-513. https://doi.org/10.1378/chest.13-2250.

Laws D, Neville E, Duffy J; Pleural Diseases Group, Standards of

Care Committee, British Thoracic Society. BTS guidelines for the

insertion of a chest drain. Thorax 2003; 58 Suppl 2(Suppl 2): ii53-


Ablett DJ, Navaratne L, Chua D, Streets CG, Tai NRM. The

modified 'Jo'burg' technique for securing intercostal chest

drains. J R Army Med Corps 2017; 163(5): 319-323.


Karunakaran T, Chukwulobelu R, Bulstrode N. A sailor's knot to

keep your drain in port. J Plast Reconstr Aesthet Surg 2013;

(3): e87-88. https://doi.org/10.1016/j.bjps.2012.11.011

Shokrollahi K. A simple method for securing a surgical drain.

Ann R Coll Surg Engl 2005; 87(5): 388.

Maritz D, McLauchlan C. A novel way to secure a chest drain.

Ann R Coll Surg Engl 2014; 96(1): 82.


Jategaonkar PA, Yadav SP. Surgical tube-drain: a rapid method

of its secure fixation. J Coll Physicians Surg Pak 2014; 24(4): 296.

O'Flynn P, Akhtar S. Effective securing of a drain. Ann R Coll

Surg Engl 1999; 81(6): 418-419.

Forshaw MJ, Clarke JM. A non-sutured method of drain fixation.

Ann R Coll Surg Engl 2004; 86(4): 308.

Jandhyala R, Healy C. A new technique for securing drains to

the scalp. Ann R Coll Surg Engl 2007; 89(7): 726.


Clark LA, Clark MH, Ball DR. A simple way of securing drains.

Br J Oral Maxillofac Surg 2007; 45(7): 602.


Heskin L, Cahill V, Filobbos G, Regan P, O'Sullivan ST, Bryan K.

A new adaptation for a secure surgical drain placement and a

comparison with four common drain fixation methods. Ann R

Coll Surg Engl 2019; 101(1): 60-68.


Lim PV, Jalaludin MA. An alternative method for securing

surgical drains in the neck. Med J Malaysia 2000; 55(1): 141-142.

Akarca D, Durnford AJ, Ewbank FG, Hempenstall J, Sadek AR,

Gould AER, et al. An Evaluation of Commonly Used External

Ventricular Drain Securement Methods in a Porcine Model:

Recommendations to Improve Practice. World Neurosurg 2018;

: e197-e202. https://doi.org/10.1016/j.wneu.2017.10.138




How to Cite

Raza A, Yasser Saeed, Majeed FA, Waqas A, Ashraf I, Masood S. Efficacy of Fixing Chest Tube to Chest Wall from Both Sides versus Single Side Fixation with Silk One Breaded Suture. Pak Armed Forces Med J [Internet]. 2024 Apr. 29 [cited 2024 May 24];74(2):489-92. Available from: https://pafmj.org/PAFMJ/article/view/9478



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