Early Complications of Open Surgical Tracheostomy

Ahmed Haris Khan; Habiburehman Afridi; Muhammad Tariq

doi:10.70749/ijbr.v2i02.331

Authors

Ahmed Haris Khan Department of ENT, MTI-Lady Reading Hospital, Peshawar, KP, Pakistan.
Habiburehman Afridi Department of ENT, MTI-Lady Reading Hospital, Peshawar, KP, Pakistan.
Muhammad Tariq Department of ENT, MTI-Lady Reading Hospital, Peshawar, KP, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v2i02.331

Keywords:

Tracheostomy, Airway Obstruction, Tracheostomy Complications

Abstract

Background: Tracheostomy is an ancient surgical intervention for managing airway obstruction, with evidence of its use dating back to 3600 BCE. It gained widespread application during the polio epidemic, particularly following the introduction of standardized techniques by Chevalier Jackson in the 20th century, which improved safety and outcomes. The objective was to evaluate the early complications associated with open surgical tracheostomy. Methodology: A cross-sectional study was conducted in the Department of ENT at MTI - Lady Reading Hospital, Peshawar. The study was conducted over six months, from July 29, 2022, to January 29, 2023. A total of 159 patients undergoing open surgical tracheostomy were included using non-probability consecutive sampling. Data on patient demographics, area of residence, and early complications were collected and analyzed. Results: The age distribution of participants was as follows: 18–30 years (18.2%), 31–40 years (33.3%), 41–50 years (13.2%), 51–60 years (26.4%), and 60–70 years (8.8%), with a mean age of 45.72 years ± 2.45. Females constituted 59.1% of the cohort, and rural residents comprised 57.2%. The most common early complications were surgical emphysema (44.7%), followed by infection (38.4%) and tube obstruction (17.0%). Conclusion: Open surgical tracheostomy remains vital for managing upper airway obstruction and facilitating prolonged mechanical ventilation. However, early complications such as surgical emphysema and infection are significant concerns, particularly in patients with more complex surgical revisions. Improved surgical techniques and postoperative care are crucial to minimizing these complications.

Downloads

Download data is not yet available.

References

Brenner, M. J., Pandian, V., Milliren, C. E., Graham, D. A., Zaga, C., Morris, L. L., Bedwell, J. R., Das, P., Zhu, H., Lee Y. Allen, J., Peltz, A., Chin, K., Schiff, B. A., Randall, D. M., Swords, C., French, D., Ward, E., Sweeney, J. M., Warrillow, S. J., … Roberson, D. W. (2020). Global tracheostomy collaborative: Data-driven improvements in patient safety through multidisciplinary teamwork, standardisation, education, and patient partnership. British Journal of Anaesthesia, 125(1), e104-e118. https://doi.org/10.1016/j.bja.2020.04.054

Khaja, M., Haider, A., Alapati, A., Qureshi, Z. A., & Yapor, L. (2022). Percutaneous tracheostomy: A bedside procedure. Cureus. https://doi.org/10.7759/cureus.24083

Lubianca Neto, J. F., Castagno, O. C., & Schuster, A. K. (2022). Complications of tracheostomy in children: A systematic review. Brazilian Journal of Otorhinolaryngology, 88(6), 882-890. https://doi.org/10.1016/j.bjorl.2020.12.006

Woods, L., Lobe, T. E., & Russell, J. (2023). Tracheostomy. Pediatric Surgery, 373-383. https://doi.org/10.1007/978-3-030-81488-5_30

Muscat, K., & Sood, S. (2024). Percutaneous tracheostomy and open standard surgical tracheostomy. Springer Surgery Atlas Series, 47-55. https://doi.org/10.1007/978-3-031-36593-5_4

Murray, M., Shen, C., Massey, B., Stadler, M., & Zenga, J. (2022). Retrospective analysis of post-tracheostomy complications. American Journal of Otolaryngology, 43(2), 103350. https://doi.org/10.1016/j.amjoto.2021.103350

Sutthipongkiat, E., Chumpathong, S., Boonmak, L., Panyamee, S., Vorasanon, K., & Mangmeesri, P. (2024). Emergency tracheostomy: Complications, anesthetic techniques, and outcomes. Ear, Nose & Throat Journal. https://doi.org/10.1177/01455613241238620

Sovtic, A., Gojsina, B., Baljosevic, I., & Popovic, S. (2024). Tracheostomy in infants: Indications and outcomes. Vojnosanitetski pregled, 81(6), 356-361. https://doi.org/10.2298/vsp240125028s

Zouk, A. N., & Batra, H. (2021). Managing complications of percutaneous tracheostomy and gastrostomy. Journal of Thoracic Disease, 13(8), 5314-5330. https://doi.org/10.21037/jtd-19-3716

Lee, M., & Wilson, H. (2021). Complications of tracheostomy. Shanghai Chest, 5, 42-42. https://doi.org/10.21037/shc-21-21

Pandian, V., Atkins, J. H., Freeman-Sanderson, A., Prush, N., Feller-Kopman, D. J., McGrath, B. A., & Brenner, M. J. (2023). Improving airway management and tracheostomy care through interprofessional collaboration: Aligning timing, technique, and teamwork. Journal of Thoracic Disease, 15(5), 2363-2370. https://doi.org/10.21037/jtd-23-205

Alsunaid, S., Holden, V. K., Kohli, A., Diaz, J., & O’Meara, L. B. (2021). Wound care management: Tracheostomy and gastrostomy. Journal of Thoracic Disease, 13(8), 5297-5313. https://doi.org/10.21037/jtd-2019-ipicu-13

Manickavasagam, J., Turner, M., Ofo, E., Kennedy, M., Thiagarajan, S., & Fancy, T. (2024). Management of emergencies and complications in head and neck practice. Stell & Maran's Head and Neck Surgery and Oncology, 274-300. https://doi.org/10.1201/9781003515227-18

Strober, W., Kallogjeri, D., Piccirillo, J. F., & Rohlfing, M. L. (2024). Tracheostomy incidence and complications: A national database analysis. Otolaryngology–Head and Neck Surgery, 171(5), 1379-1386. https://doi.org/10.1002/ohn.843

Liu, Y., Zhou, C., Wu, Y., Deng, S., Chen, Y., & Zhou, J. (2023). Tracheostomy tube changes in patients with tracheostomy: A quality improvement project. Nursing in Critical Care, 29(6), 1470-1478. https://doi.org/10.1111/nicc.13008

Rezk Abdou Barakat, B., Mohamed Esmat, O., & Talaat Mohamed, A. (2024). Health needs and problems of patients with permanent tracheostomy. Egyptian Journal of Health Care, 15(4), 353-367. https://doi.org/10.21608/ejhc.2024.387319

Nyanzi, D. J., Atwine, D., Kamoga, R., Birungi, C., Nansubuga, C. A., Nyaiteera, V., & Nakku, D. (2023). Tracheostomy-related indications, early complications and their predictors among patients in low resource settings: A prospective cohort study in the pre-COVID-19 era. BMC Surgery, 23(1). https://doi.org/10.1186/s12893-023-01960-5

Yadav, M., Yadav, G., Monga, J., Hussain, R. T., & Naik, S. M. (2022). Indications and complications of paediatric tracheostomies at a tertiary care centre in rural Haryana: A retrospective study. International Journal of Otorhinolaryngology and Head and Neck Surgery, 8(2), 100. https://doi.org/10.18203/issn.2454-5929.ijohns20220010

Alnemare, A. K. (2024). Age-specific differences in Laryngotracheal trauma characteristics: A retrospective study of clinical profiles, outcomes, and mortality risk. Journal of Clinical Medicine, 13(12), 3508. https://doi.org/10.3390/jcm13123508

Levy, L., Smiley, A., & Latifi, R. (2022). Mortality risk factors in patients admitted with the primary diagnosis of tracheostomy complications: An analysis of 8026 patients. International Journal of Environmental Research and Public Health, 19(15), 9031. https://doi.org/10.3390/ijerph19159031

Abhisha, C., Uma, N., & Babu, R. (2022). STUDY OF INCIDENCE, INDICATIONS OF TRACHEOSTOMY IN RELATION TO AGE AND SEX AT A TERTIARY HOSPITAL. Int J Acad Med Pharm, 4(5), 728-732.

Selekwa, M., Maina, I., Yeh, T., Nkya, A., Ncogoza, I., Nuss, R. C., Mushi, B. P., Haddadi, S., Van Loon, K., Mbaga, E., Massawe, W., Roberson, D. W., Dharsee, N., Musimu, B., & Xu, M. J. (2023). Tracheostomy care quality improvement in low- and middle-income countries: A scoping review. PLOS Global Public Health, 3(11), e0002294. https://doi.org/10.1371/journal.pgph.0002294