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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.
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.
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