Tracheostomy with inferior tracheal suture to superficial neck planes: Analysis of the experience in the Intensive Care Unit

Abstract

Tracheostomy is a frequently practiced surgical procedure in the Intensive Care Unit (ICU) that may have complications such as hemorrhage, subcutaneous emphysema, pneumothorax, accidental decannulation and formation of third spaces when repositioning a tracheostome tube. In this sense, the tracheostomy technique with tracheal suture inferior to the subcutaneous tissue is proposed as an alternative to reduce complications. Objectives: To analyze the experience obtaining describing the epidemiological characteristics and basic diagnoses in tracheostomized patients, establishing the average days under endotracheal intubation in which it is performed and the index of early complications that occur. Method: A review of the histories and analysis of the information found was carried out by calculating the mean of the continuous variables; in the case of nominal variables, their frequencies and percentages were calculated. Results: No intraoperative complications were found. The early complications found were mechanical obstruction present in 13.79% of the sample and hemorrhage in 3.44%, all with satisfactory resolution. In cases of programmed tracheostome replacement, no complications were found. Conclusions: The tracheostomy technique with tracheal suture to subcutaneous tissue reduces the risks of creating a false pathway when trying to reposition the tracheostome. Complications such as hemorrhage, subcutaneous emphysema or pneumothorax, maintains a low or null rate of appearance when the surgical technique and anatomy are known and the patient does not have aggravating factors. It is important to individualize a patient before deciding to perform a tracheostomy. Proper management of the tracheostome during the postoperative period is crucial to avoid complications.