Page 20 - JSOM Spring 2025

purpose of a chest seal is to manage airflow through the chest open chest wound. Ensuring that not all channels are filled
wound, the inability to properly allow blood drainage will se- with fluid, in the case of a hemopneumothorax or pleural effu-
verely impact the efficiency of the chest seal to treat an open sion, should reduce the chance of a complete blockage due to
pneumothorax. This study will aim to determine the effects clotting, which prohibits the chest seal from properly venting.
of specific chest seal characteristics on the fluid drainage effi- Each novel chest seal had a diameter of 15.25cm and consisted
ciency of commercially available chest seals compared to novel of a series of main channels stemming from the central wound
designs at relevant physiological pressures. site and side channels, which branch off the main channels
(Figure 2). The main channels are all approximately 2-cm wide
and the side channels are of varying size, quantity, and orien-
Methods
tation for each design (Table 1). Design specifications for the
Articles Under Test commercial chest seals are shown in Table 2.
Six commercially available chest seals were selected for test-
ing (Figure 1a). Bolin (Safeguard Medical, Huntersville, NC), FIGURE 2 Novel chest seal design nomenclature. Each novel chest
SAM (SAM Medical, Wilsonville, OR), Russel (Safeguard seal has main channels which extend from the wound site to chest
Medical, Huntersville, NC), Sentinel (Combat Medical, Har- seal perimeter. Side channels extend from main channel to chest seal
risburg, NC), and Hyfin (North American Rescue, Greer, SC) perimeter. Chest seals can have single side channel (A) or multiple
chest seals were chosen from a study by Kheirabadi et al. ; side channels per main channel (B).
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the H*VENT (H&H Medical, Williamsburg, VA) was also (A) (B)
included. Laminar chest seal designs were primarily chosen
because of their superior performance over flutter valve chest
seals when observing different physiological metrics in swine
models. Eight novel chest seal designs (Figure 1b) were cre-
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ated and tested alongside the commercial chest seals.
FIGURE 1 Commercial chest seals (A) and novel chest seals (B) tested
in this study.
(A)

TABLE 1 Channel Design Specifications for the Novel Chest
Seal Designs
No. of total exit Average channel Total channel
Design channels width, cm area, cm 2
A 6 1.75 81.4
B 9 1.67 110.2
C 9 2.1 117.0
D 9 1.81 92.3
E 12 1.90 118.8
F 12 2.14 115.6
G 12 2.00 122.4
H 16 1.90 151.4
Note: Exit channels are the number of channels on the outer circum-
ference of the chest seal. Channel width and total channel area are
(B) approximations from channel lengths and widths.

TABLE 2 Channel Design Specifications for the Commercial
Chest Seals
No. of total exit Average channel Total channel
Brand name channels (vents) width, cm area, cm 2
Russel 4 1.2 74.6
Sentinel 2 3.5 77.0
Hyfin 3 1.0 48.6
H*VENT 6 1.0 41.4
SAM 1 3.0 8.04
Bolin 3 0.8 21.8
Note: Exit channels are the number of openings to the outside of the
chest seal. Channel width and total channel area are approximations
from channel lengths and widths.
The design of the novel chest seals was done with two pur-
poses in mind. The first was to optimize the fluid drainage Experimental Design
rate through the chest seals. The second was to design a lami- The tidal volume and subsequent pressure flowing through
nar geometry that separates the fluid and air expired from an the chest seal can vary drastically, from normal, to labored

18 | JSOM Volume 25, Edition 1 / Spring 2025