Self-locking Knot for Thoracic Wall Closure in Trauma Anterolateral Thoracotomy: A Retrospective Cohort Study.

BACKGROUND: Thoracic trauma is one of the most frequent reasons for consultation in emergency departments worldwide. Surgical management of unstable injuries remains a challenge for trauma surgeons, as current evidence regarding chest wall closure techniques does not yet support a clear consensus. Although multiple techniques have been described, no single approach has been universally adopted. METHODS: We performed a retrospective cohort study comparing the results for operative time, surgical site infection and postoperative pain between closures using the self-locking knot versus the rib approximator. RESULTS: Our results demonstrate a difference between the 2 techniques analyzed that could be significant in terms of postoperative pain (18% for the self-locking knot group vs 65% for the rib approximator), surgical site infections (0% vs 9%, respectively) and operative time (100 versus 110 minutes, respectively). CONCLUSION: The self-locking knot technique could be considered a promising option for the intercostal space after anterolateral thoracotomy closure. Further studies are needed to confirm these results.