Fig. 1.

Technique of chest drain wound closure and chest tube removal. From Kim et al. Ann Thorac Surg 2017;103:e93–5 [2]. (A) After suturing the muscle layer, closure of wound using knotless sutures begins at the one end of an incision. Instead of tying the knot, the tip of the needle enters through the fixation loop and is tightened. (B) The needle is placed horizontally through the subcutaneous tissue by passing through the opposite sides of the wound exactly same as in the continuous subcutaneous suture technique. (C) The suture continues around the chest tube until the needle reaches the other end of the incision. (D) At the other end of the incision, the tip of the needle passes under the skin and comes out through the skin about 1 cm away from the edge of the incision. (E) After the chest tube is removed, the secured thread is pulled forward to tighten the suture. Then the wound is sealed as with a zipper. (F) Leftover thread is cut off and nothing is left over at the scar of the chest tube site.