TissueDB/Simulators/Chest Tube Simulator (Man-O-War)
General Information
The Man-O-War Chest Tube Simulator is a low-cost manikin for training chest tube insertion (tube thoracostomy) and management, developed at Habib Bourguiba University Hospital, Sfax, Tunisia. The simulator uses a funnel-shaped plastic bucket as a thorax frame, with plaster bandage–wrapped ribs, a gaffer tape and cellophane assembly simulating the parietal pleura, and dense foam representing the chest wall soft tissues. Total material cost is approximately US$15 with a build time of approximately 1 hour. The simulator supports the complete chest tube insertion procedure: rib palpation, skin incision, blunt dissection, pleural puncture, tube placement, and suturing. Each intercostal space permits up to 3 insertion attempts, yielding approximately 30 total attempts per chest wall before replacement is required. The parietal wall and pleura layers can be replaced in approximately 15 minutes.[1]
| Field | Details |
|---|---|
| General Information | Low-fidelity, low-cost manikin for chest tube insertion training constructed from household materials. Developed by Abdennour Nasri, Mouna Jerbi, and colleagues at the Emergency Department, Habib Bourguiba University Hospital, and the Emergency Department, Gabes University Hospital (both Faculty of Medicine, Sfax University, Tunisia).[1] Positioned by the authors as a low-cost alternative to 3D-printed thorax designs (Bettega 2019, approximately US$133), modified mannequins with animal tissue (Tatli 2017, approximately US$50; Young 2019, approximately US$198), and high-fidelity commercial trainers (thousands to tens of thousands of US dollars).[1] Source: Nasri et al., African Journal of Emergency Medicine, 2023. |
| Features and Basic Operation | Not stated in source |
| Current Development Status | Pilot-tested with 154 emergency medicine practitioners total: 80 at the 22nd congress of the Tunisian Emergency Medicine Society (STMU), May 2022, and 74 at a national congress of emergency medicine. No peer-reviewed validation study has been published; the authors state "satisfactory survey will be published soon".[1] |
| Estimated Build Time and Cost | Approximately 1 hour build time; approximately US$15 total material cost |
| Specialized Tools and Equipment | Permanent marker, straight grinder machine |
| Version | Not stated in source |
| Development Team Contact Information | Olfa Chakroun-Walha, Emergency Department, Habib Bourguiba University Hospital, Faculty of Medicine, Sfax University, Tunisia |
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Bone (ribs) | 10 (5 pairs) | Plaster Bandage | $2.50 | Plaster strips wrapped around cut plastic to simulate rib rigidity. Source states "real sensation of bones on palpation".[1] |
| Skin + Subcutaneous Tissue (chest wall) | 1 | Polyurethane Foam | $2.50 | 60×30×5 cm "extra dur" (extra-firm) foam mattress. Specific polyurethane composition is inferred; source specifies only the French trade term "extra dur" meaning extra-firm. Source states "similar density to flesh… real feeling when palpating and introducing a drain".[1] |
| Pleura (parietal) | 1 | Gaffer Tape | $2.00 | Gaffer tape molded over cellophane along intercostal spaces. Source identifies this assembly as the parietal pleura layer only.[1] |
Structural Parts
| Part Name | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Thorax frame | 1 | Funnel-shaped plastic bucket (upper ∅ 20 cm, lower ∅ 35 cm, length 30 cm) | $3.00 | Ribs cut from bucket walls. Provides structural skeleton for rib cage. |
| Pleura substrate | 1 | Cellophane paper (Plastic Film) | $1.50 | Wrapped around bucket before gaffer tape layer. Provides base for pleura assembly. |
| Support base | 1 | Basin with 5 kg white cement | $3.50 | Bucket fixed into cement-filled basin for stability during procedures. |
| Fasteners | ~8 | Screws and nuts | (incl.) | Secure foam mattress to bucket frame. |
Build Instructions
Phase 1: Frame Construction
- Acquire frame. Buy a funnel-shaped plastic bucket with upper diameter 20 cm, lower diameter 35 cm, and length 30 cm.
- Mark rib layout. Draw rib cage on bucket with permanent marker. Place sternum line in the middle. Mark 5 pairs of ribs laterally on both sides. Make ribs 2 cm wide and 10–15 cm long. Leave intercostal spaces 2 cm wide.
- Cut intercostal spaces. Cut the plastic between ribs using a straight grinder to individualize each intercostal space.
✓ Verify: Each rib is individually defined with open, accessible intercostal spaces between them.
Phase 2: Tissue Layers
- Apply bone simulation. Cut plaster casting roll (plaster bandage) into 4 cm strips lengthwise. Wrap strips around each rib, flatten with fingers, and overlap each pass. Allow plaster to dry completely. Ribs become stiff at approximately 1 cm width.
✓ Verify: Dried ribs are rigid. Palpation produces firm bone-like resistance.
- Apply pleura substrate. Roll cellophane paper around the bucket, covering all intercostal spaces.
- Apply pleura simulation. Place gaffer tape along the intercostal spaces and mold firmly over the spaces.
✓ Verify: Gaffer tape covers all intercostal spaces. Cellophane-tape assembly provides consistent puncture resistance across all spaces.
- Attach chest wall. Anchor a 60 × 30 × 5 cm "extra dur" (extra-firm) foam mattress to the bucket with screws and nuts.
✓ Verify: Foam is secure. Rib positions and intercostal spaces are palpable through foam.
Phase 3: Base Assembly
- Create support base. Fill a basin with 5 kg melted white cement. Fix the bucket into the cement-filled basin. Allow cement to set completely before use.
✓ Verify: Simulator stands upright without external support. Base remains stable during chest tube insertion force.
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 Nasri A, Jerbi M, Karray R, Snoussi H, Samet A, Talbi A, Ksentini H, Rejeb I, Chakroun-Walha O, Rekik N (2023). "Man-O-War simulator: a Low-cost manikin for training on chest tube management." African Journal of Emergency Medicine 13(2):39–41. DOI: 10.1016/j.afjem.2023.01.004. PMID: 36864887.
| Alternative names | Man-O-War simulator Man-O-War manikin |
|---|
| Authors | Arturopelayo |
|---|---|
| License | CC-BY-SA-4.0 |
| Cite as | Arturopelayo (2026). "TissueDB/Simulators/Chest Tube Simulator (Man-O-War)". Appropedia. Retrieved June 4, 2026. |