Usefulness and Safety of Open Tracheostomy by a Paramedian Approach for Cervical Infection: Esophageal and Tracheal Injury and Necrotizing Fascitis
Tracheostomy is hardly performed in patients with cervical infection close to the site of the tracheostomy. This study aimed to present and clarify the usefulness and safety of open tracheostomy performed by the paramedian approach technique. The procedure is as follows. A 2.5-cm paramedian incision...
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Published in | The American surgeon Vol. 76; no. 11; pp. 1251 - 1254 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
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Atlanta, GA
Southeastern Surgical Congress
01.11.2010
SAGE PUBLICATIONS, INC |
Subjects | |
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Abstract | Tracheostomy is hardly performed in patients with cervical infection close to the site of the tracheostomy. This study aimed to present and clarify the usefulness and safety of open tracheostomy performed by the paramedian approach technique. The procedure is as follows. A 2.5-cm paramedian incision is made for the tracheostomy on the opposite side of infectious focus; the anterior neck muscles are dissected and split; the trachea is fenestrated by a reverse U-shaped incision; and the fenestral flap of the trachea is fixed to the skin. We used this technique in five patients. There were no complications such as bleeding, desaturation, and displacement of the tube; and there were no postoperative complications such as severe contamination or infection of the tracheostomy site from the nearby cervical wound, difficulty in securing the tracheostomy tube and connecting device to the ventilator, difficulties in daily management and care, or dislocation of the tracheostomy tube. All wounds resulting from the tracheostomy were kept separate from and not contaminated by the nearby dirty wounds. Open tracheostomy by the paramedian approach technique is useful and safe for patients with severe cervical infection requiring open drainage and long ventilatory management. |
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AbstractList | Tracheostomy is hardly performed in patients with cervical infection close to the site of the tracheostomy. This study aimed to present and clarify the usefulness and safety of open tracheostomy performed by the paramedian approach technique. The procedure is as follows. A 2.5-cm paramedian incision is made for the tracheostomy on the opposite side of infectious focus; the anterior neck muscles are dissected and split; the trachea is fenestrated by a reverse U-shaped incision; and the fenestral flap of the trachea is fixed to the skin. We used this technique in five patients. There were no complications such as bleeding, desaturation, and displacement of the tube; and there were no postoperative complications such as severe contamination or infection of the tracheostomy site from the nearby cervical wound, difficulty in securing the tracheostomy tube and connecting device to the ventilator, difficulties in daily management and care, or dislocation of the tracheostomy tube. All wounds resulting from the tracheostomy were kept separate from and not contaminated by the nearby dirty wounds. Open tracheostomy by the paramedian approach technique is useful and safe for patients with severe cervical infection requiring open drainage and long ventilatory management. [PUBLICATION ABSTRACT] Tracheostomy is hardly performed in patients with cervical infection close to the site of the tracheostomy. This study aimed to present and clarify the usefulness and safety of open tracheostomy performed by the paramedian approach technique. The procedure is as follows. A 2.5-cm paramedian incision is made for the tracheostomy on the opposite side of infectious focus; the anterior neck muscles are dissected and split; the trachea is fenestrated by a reverse U-shaped incision; and the fenestral flap of the trachea is fixed to the skin. We used this technique in five patients. There were no complications such as bleeding, desaturation, and displacement of the tube; and there were no postoperative complications such as severe contamination or infection of the tracheostomy site from the nearby cervical wound, difficulty in securing the tracheostomy tube and connecting device to the ventilator, difficulties in daily management and care, or dislocation of the tracheostomy tube. All wounds resulting from the tracheostomy were kept separate from and not contaminated by the nearby dirty wounds. Open tracheostomy by the paramedian approach technique is useful and safe for patients with severe cervical infection requiring open drainage and long ventilatory management. |
Author | TOYODA, Hiroshi KOSUGE, Takayuki IWASHITA, Masayuki SUZUKI, Noriyuki SUGIYAMA, Mitsugi ARATA, Shinju HARUNARI, Nobuyuki MORIWAKI, Yoshihiro |
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Keywords | Digestive system Toxicity Tracheotomy Respiratory system Trauma Female genital diseases Esophagus Respiratory tract Medicine Treatment Surgery Cervicitis Lesion Safety Trachea Uterine cervix diseases |
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References | bibr8-000313481007601127 Grillo H.C. (bibr14-000313481007601127) 1986 Khalili T.M. (bibr7-000313481007601127) 2002; 68 bibr9-000313481007601127 bibr11-000313481007601127 bibr5-000313481007601127 bibr15-000313481007601127 bibr6-000313481007601127 Moriwaki Y. (bibr13-000313481007601127) 2006; 32 bibr3-000313481007601127 bibr1-000313481007601127 Blot F. (bibr4-000313481007601127) 2005; 127 bibr2-000313481007601127 bibr17-000313481007601127 bibr18-000313481007601127 bibr19-000313481007601127 bibr16-000313481007601127 bibr10-000313481007601127 Moriwaki Y. (bibr12-000313481007601127) 2001; 27 |
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SubjectTerms | Bacterial diseases Bacterial diseases of the genital system Biological and medical sciences Drainage - methods Esophageal Diseases - surgery Esophagus - injuries Fasciitis, Necrotizing - surgery General aspects Human bacterial diseases Humans Infectious diseases Medical sciences Neck Neck Muscles - surgery Nursing Surgical Flaps Surgical Wound Infection - surgery Trachea - injuries Tracheostomy - methods Ventilation |
Title | Usefulness and Safety of Open Tracheostomy by a Paramedian Approach for Cervical Infection: Esophageal and Tracheal Injury and Necrotizing Fascitis |
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