A novel way to secure a chest drain

TECHNIQUE After drain insertion, a horizontal mattress suture is placed. A simple knot is placed distally half way along the two free ends. The two threads are wrapped tightly together the same way around the tube up to the level of the knot. The free ends of the knot are then passed proximally under the loop of the skin suture (Fig 1). The suture is pulled fi rmly, and the free ends are separated and wrapped around the tube in opposite directions a few times. The two ends are tied together tightly using a surgeon’s knot. Traction on the tube tightens the wound and the grip on the tube (Fig 2). The same suture is used to close the skin by unwrappping the threads and cutting them just proximal to the fi rst knot placed (Fig 2).