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Published on: March 15, 2024
Semi-open percutaneous tracheostomy in burn patients
Michael J Feldman1, Stephen M Milner, Kamal M Dhanjani
1Evans-Haynes Burn Center, Virginia Commonwealth University, 1213 East Clay St., Richmond, VA, United States. mfeldman@mcvh-vcu.edu
Summary
A modified semi-open percutaneous tracheostomy offers a safe and effective airway management alternative for burn patients. This technique combines minimally invasive benefits with enhanced surgical control, reducing complications.
Area of Science:
- Surgical techniques
- Critical care
- Burn management
Background:
- Percutaneous tracheostomy is a common procedure.
- Burn patients present unique challenges for airway management.
- Existing tracheostomy methods may have limitations in this population.
Purpose of the Study:
- To describe a semi-open percutaneous tracheostomy technique.
- To evaluate its safety and effectiveness in burn patients.
- To compare it with open and standard percutaneous tracheostomy.
Main Methods:
- A modified semi-open percutaneous tracheostomy was performed between 2005-2007.
- The technique involved a small incision and limited dissection.
- Tracheal entry and dilation were achieved using standard percutaneous equipment.
Main Results:
- 39 burn patients underwent the procedure, with 30 at the bedside.
- Average time to tracheostomy was 19 days, with 42% total body surface area burns.
- No procedure-related deaths occurred; one case of intraoperative hemorrhage was managed successfully.
Conclusions:
- The semi-open percutaneous tracheostomy is a safe and effective alternative for burn patients.
- It offers advantages of both percutaneous and open techniques.
- This method provides improved surgical control while maintaining minimally invasive benefits.
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