Faculty Collaboration Database

Neither Skin Sutures nor Foam Dressing Use Affect Tracheostomy Complication Rates. J Surg Res 2021 Apr;260:116-121

Date

12/19/2020

Pubmed ID

33338887

DOI

10.1016/j.jss.2020.11.066

Scopus ID

2-s2.0-85097765714 (requires institutional sign-in at Scopus site)   3 Citations

Abstract

BACKGROUND: Tracheostomy is commonly used for managing the airway of trauma patients. Complications are common and result in increased length of stays and treatment cost. The aim of this study is to evaluate whether the utilization of skin sutures or foam barrier dressings affect tracheostomy complication rates.

MATERIALS AND METHODS: This is a single-center retrospective review of patients who underwent a tracheostomy by the trauma service between January 2014 and December 2017. Collected variables included demographics, patient history, treatment variables, complications, and outcomes. Univariate and multivariate analyses were constructed to identify significant predictors for the development of complications.

RESULTS: A total of 268 patients were included. The median age was 43.5 y, 221 (82.5%) patients were men, and the median BMI was 28 (IQR 24.6, 32.2). Most (87.3%) of the procedures were performed in the operating room and 82.5% were open. Skin sutures were used in 46.3% and 53.4% had a foam barrier dressing placed. Current smoking [OR 8.1 (95% CI 1.5, 43.6)] and BMI [OR 1.1 (95% CI 1.03, 1.2)] significantly increased the risk of developing pressure necrosis. Use of sutures or foam dressings was not associated with pressure necrosis, bleeding, or surgical site infection. There were no unexpected tracheostomy decannulations regardless of the use of skin sutures.

CONCLUSIONS: Suturing the tracheostomy or applying a foam barrier dressing was not associated with overall complications or decannulation rates. Based on our data, we suggest that skin sutures may be safely abandoned.

Author List

Zein Eddine SB, Carver TW, Karam BS, Pooni I, Ericksen F, Milia DJ

Authors

Thomas W. Carver MD Associate Professor in the Surgery department at Medical College of Wisconsin
David J. Milia MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Aged, 80 and over
Bandages
Female
Humans
Male
Middle Aged
Postoperative Complications
Retrospective Studies
Risk Factors
Sutures
Tracheostomy
Wound Closure Techniques
Young Adult