{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T16:11:19Z","timestamp":1778083879954,"version":"3.51.4"},"reference-count":13,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2025,11]]},"abstract":"\n Introduction<\/jats:title>\n Our study proposes to define accuracy of and identify areas in general surgery residents (GSR) chest tube thoracostomy (CTT) placement addressable by improved education and supervision.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Prospective study of resident-performed CTT from June-August 2023 and 2024 in two Level 1 trauma centers. Data collection\/analysis included demographics, tube type, proceduralist PGY, placement accuracy, patient factors, and outcomes.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Seventy-seven CTT were placed by GSR. Average patient age was 57 \u00b1 16.8. 75% were male. Smokers, COPD diagnosis, and prior chest wall radiation patients experienced more resident-CTT placement errors. CTT were standard 28-32F tubes (58; 75%) and small-bore pleural catheters (19; 25%). CTT was adequate in 62 (80.5%), 19.5% were sub-optimal. Placement problems included sentinel hole outside the chest (7, 9.1%), extrapleural location (5, 6.5%), kinked tube (3, 3.9%), and ineffective fissural tube (1, 1.3%). Interns placed 41 CTT, 7 by PGY-2, 11 by PGY-3, 7 by PGY-4, and 10 PGY-5 surgery residents. PGY-1 residents had a higher incidence of CTT retraction (35%,\n P<\/jats:italic>\n = 0.042). Retracted, poorly secured CTT had a longer duration compared to well-secured CTT (6\u00a0days [4-7] vs 3 [2-4],\n P<\/jats:italic>\n = 0.019); but didn\u2019t affect hospital LOS (\n P<\/jats:italic>\n = 0.651). No other differences based on PGY were noted.\n <\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n GSR\u2019s CTT placement has an accuracy of 80%. Placement problems occur at all levels of residency training. Our findings highlight actionable training targets and recommend areas of enhanced supervision to improve GSR mastery of CTT.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/00031348251363542","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:28:40Z","timestamp":1753835320000},"page":"1834-1839","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Prospective Evaluation of Chest Tube Thoracostomy Placement by General Surgery Residents at Two Level I Trauma Centers"],"prefix":"10.1177","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9935-4410","authenticated-orcid":false,"given":"Zachary","family":"Shelton","sequence":"first","affiliation":[{"name":"Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baytes Gabriel","family":"Regan-Jordan","sequence":"additional","affiliation":[{"name":"Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinila","family":"Baljepally","sequence":"additional","affiliation":[{"name":"Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tyler","family":"Locke","sequence":"additional","affiliation":[{"name":"Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chase","family":"Hayman","sequence":"additional","affiliation":[{"name":"Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ethan","family":"Ward","sequence":"additional","affiliation":[{"name":"Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"King","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Tennessee Medical Center, Knoxville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lou","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Tennessee Medical Center, Knoxville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,7,29]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.4103\/2229-5151.134182"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.3205\/zma001063"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinsp.2024.100399"},{"key":"e_1_3_5_5_2","volume-title":"Advanced Trauma Life Support, ATLS\u00ae Student Course Manual","author":"American College of Surgeons","year":"2018","unstructured":"American College of Surgeons. Advanced Trauma Life Support, ATLS\u00ae Student Course Manual. 9th ed. Chicago: ACS; 2018.","edition":"9"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/postgradmedj-2018-136380"},{"issue":"6","key":"e_1_3_5_7_2","first-page":"450","article-title":"Chest tube complications: how well are we training our residents?","volume":"50","author":"Ball CG","year":"2007","unstructured":"Ball CG, Lord J, Laupland KB, et al. Chest tube complications: how well are we training our residents? Can J Surg. 2007;50(6):450-458.","journal-title":"Can J Surg"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-018-0966-z"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2021.11.031"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","unstructured":"Platnick C Witt CE Pieracci FM Beyond the tube: Can we reduce chest tube complications in trauma patients? Am J Surg. Nov 2021;222(5):1023-1028. doi: 10.1016\/j.amjsurg.2021.04.008 Epub 2021 Apr 20. 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