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Tracheostomy: Procedure and Tubes

Tracheostomy: Procedure and Tubes

A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...

Tracheostomy Care II: Procedure

Tracheostomy Care II: Procedure

Tracheostomy care is an essential nursing skill that involves cleaning and maintaining a tracheostomy tube to prevent infection and other complications. Here's a step-by-step guide explaining each procedure with its rationale. Note that disposable gloves are to be worn at all times and changed as often as needed to maintain a sterile work environment, and to protect both patient and healthcare worker.
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask and...

Tracheostomy Care I: Pre-procedural Steps

Tracheostomy Care I: Pre-procedural Steps

A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
The equipment necessary for tracheostomy care includes:

Oxygen Delivering System III: Tracheostomy and T-piece

Oxygen Delivering System III: Tracheostomy and T-piece

Oxygen delivery is critical in clinical care, especially for patients with respiratory disorders or those undergoing surgical procedures. Various systems, such as tracheostomy and the T-piece, deliver oxygen to the lungs, ensuring adequate arterial oxygenation.
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...

Tracheostomy Decannulation

Tracheostomy Decannulation

Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...

Tracheostomy Suctioning II: Procedure

Tracheostomy Suctioning II: Procedure

Tracheostomy suctioning is a vital nursing procedure that involves removing secretions from the tracheostomy tube to maintain airway patency and prevent respiratory complications. Nurses need to understand the proper technique for tracheostomy suctioning to ensure patient safety and comfort. In this guide, we will outline the step-by-step process for performing tracheostomy suctioning, including preparing the sterile field, donning personal protective equipment (PPE), lubricating and connecting...

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Updated: Jul 17, 2026

The Rigid Tube as an Alternative in Controlling the Problematic Airway

The Rigid Tube as an Alternative in Controlling the Problematic Airway

Published on: June 6, 2020

Tracheostomy tape: more trouble than it's worth?

G A E Burke¹, F Bekiroglu, A M S Brown

¹Maxillofacial Unit, University Hospital Birmingham NHS Foundation Trust, Edgbaston, Birmingham B15 2TH, UK. Ezra.burke@uhb.nhs.uk

International Journal of Oral and Maxillofacial Surgery

|February 9, 2007

Summary

Tracheostomy ties in head and neck free flap surgery may risk vascular pedicle occlusion. Early ischemia detection using microdialysis can prevent potential flap failure, challenging current practices.

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Last Updated: Jul 17, 2026

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Area of Science:

Head and Neck Surgery
Microsurgery
Vascular Surgery

Background:

Tracheostomy is common in head and neck free-tissue transfer.
Removing tracheostomy tube struts is thought to reduce vascular pedicle occlusion risk by preventing cervical tape use.

Observation:

A case report details a potential flap failure due to a cervical tracheostomy tape.
The vascular pedicle of a free flap was at risk of occlusion from the tracheostomy tape.

Findings:

Microdialysis detected early ischemia in the free flap.
Prompt intervention based on microdialysis findings averted flap failure.

Implications:

The evidence supporting the removal of tracheostomy tube struts to prevent vascular obstruction is lacking.
Microdialysis offers a method for early detection of compromised free flaps in the head and neck region.
Clinical practice regarding tracheostomy management in free flap surgery may need re-evaluation.