Abstract
Introduction
Tube thoracostomy is a common procedure for which competency is expected of all trauma
providers, both surgical and nonsurgical. Although surgery residents have fewer complications
than other resident specialties, complications relating to position and insertion
are reported. We hypothesized the use of our novel chest tube placement device will
improve chest tube placement efficiency while maintaining accuracy compared to the
open Kelly clamp technique across multiple specialties.
Methods
A swine lab was conducted through an approved Institutional Animal Care and Use Committee
device testing protocol. After a preprocedure, tutorial participants placed chest
tubes with the device and Kelly clamps through predetermined incision sites. Placement
positioning was determined by a postplacement chest X-ray. One way analysis of variance
was used for intratechnique comparisons. Time to placement was compared using paired
t-test; P- values of <0.05 were considered significant.
Results
Intrathoracic device placement occurred with 94.4% (N = 68) of placements compared to 93.1% (N = 67) of Kelly clamp placements (P = 0.73). The device-placed chest tubes were apically positioned 94.4% (N = 68) compared to 66.7% (N = 48) (P < 0.01) of Kelly clamp-placed chest tubes. Novel device use chest tube placement
was significantly faster with a mean time of 39.3 (±27.7) s compared to 61.5 (±38.6)
s for the Kelly clamp (P < 0.01).
Conclusions
In this proof of concept study, our chest tube placement device improved efficiency
and accuracy in chest tube placement when compared to the open Kelly clamp technique.
This finding was consistent across thoracic trauma providers, including general surgery
residents.
Keywords
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Article info
Publication history
Published online: December 14, 2022
Accepted:
November 20,
2022
Received in revised form:
November 16,
2022
Received:
March 14,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
