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Pediatric Tracheostomy Wound Healing: A Retrospective Cohort Study
Brian H Odom1, Charlotte Yates, Leah Lowe
1Brian H. Odom, PhD, PT, CWS, is Associate Professor, Harding University, Searcy, Arkansas. At the University of Central Arkansas, Conway, Arkansas, Charlotte Yates, PhD, PT, PCS, is Professor; and Leah Lowe, PhD, PT, PCS, is an Assistant Professor. Lisa VanHoose, PhD, MPH, PT, is an Associate Professor at the University of Louisiana at Monroe.
Insights
This study found no significant difference between foam dressings and foam plus wound filler for pediatric tracheostomy wound healing. However, specific patient factors like pressure injury stage may predict faster healing with the combined dressing.
Area of Science:
- Pediatric wound care
- Dermatology
- Surgical complications
Background:
- Tracheostomy wounds in pediatric patients present unique healing challenges.
- Effective wound management is crucial to prevent complications and ensure optimal patient outcomes.
Purpose of the Study:
- To compare the efficacy of two wound dressing types in pediatric tracheostomy wounds.
- To evaluate time to granulation tissue and complete wound healing.
Main Methods:
- Retrospective chart review of 93 pediatric patients with tracheostomy wounds.
- Comparison of foam dressing versus foam dressing with wound filler.
- Primary outcomes: time to granulation tissue and wound closure.
Main Results:
- Average wound closure time was 14 days, with no statistically significant difference between dressing types.
- Pressure injury stage was the strongest predictor of healing within 14 days.
- African American patients with stage 2 pressure injury and a PUSH score ≥5 using foam plus wound filler showed an 86% higher likelihood of rapid healing.
Conclusions:
- Pediatric tracheostomy wounds healed effectively with current practices without surgery.
- Incorporating wound filler within the first 14 days may be beneficial, particularly for specific patient profiles.
Objective:
To compare wound products by measuring time to granulation tissue and time to complete wound healing for tracheostomy wounds in the pediatric population.
Methods:
Investigators identified 134 charts of patients treated January 2013 and June 2017; 93 charts met the inclusion criteria. This study compared the use of a foam dressing (n = 34) to the foam dressing plus a wound filler (n = 59) in patients who developed or were admitted with a wound caused by a tracheostomy device.
Primary Outcome Measures:
Time in days to granulation tissue and to wound closure.
Results:
The average time to complete wound closure for participants in this study was 14 days. There was no statistically significant difference in time to granulation tissue or wound closure formation between the wound care products (F2,34 = 1.11, P = .34). Cluster analysis (10 splits) revealed that pressure injury stage was the best predictor, accounting for 41% of the variance in the high treatment response group (those healing in <14 days). Patients who were African American with a stage 2 pressure injury, had a PUSH score of 5 or more, and were using a foam plus a wound filler dressing were 86% more likely to be in the high-response group.
Conclusions:
All wounds reviewed healed with current wound care practices without surgical intervention. Best practice for healing tracheostomy wounds in pediatric patients should include the wound filler in the first 14 days based on variable interaction.
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