Chest tube thoracostomy is the most common procedure performed in cardiothoracic trauma. It is used by several doctors from different specialties with different levels of experiences. However, it is not without risk, particularly when inserted in urgent conditions as in thoracic trauma by inexperienced physicians. Therefore, a sound, safe, and simple technique is warranted. There are so many published excellent videos describing chest tube insertions. , However, there are some serious complications still observed including too much dissections and tunneling with the risk of life-threatening infections such as necrotizing fasciitis.  Positioning of the tube during insertion can go wildly wrong with serious complications. , Securing the tube after insertion is almost inadequate with serious spontaneous removal of the tube.  The previously placed horizontal mattress suture will be used to close the wound cosmetically after removal of the tube.  This video reflects the author's technique  which is basically similar to that of the American Association for the Surgery of Trauma - Advanced Trauma Life Support  and others,  but it differs in some maneuvers as shown in the video to reduce the above-mentioned complications. ,,,
The author acknowledges the assistance of Dr. Vidar Möller, MD, for Minimizing the size of the video.