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Reducing Pediatric Tracheostomy Wound Complications: An Evidence-Based Literature Review
Lindsay R Baker1, Stephen R Chorney
1In Philadelphia, Pennsylvania, Lindsay R. Baker, RN, is Registered Nurse, Department of Nursing, Thomas Jefferson University Hospital; and Stephen R. Chorney, MD, MPH, is Pediatric Otolaryngologist, Division of Otolaryngology, Children's Hospital of Philadelphia and Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine. The authors have disclosed no financial relationships related to this article. Submitted November 22, 2019; accepted in revised form January 23, 2020.
Objective:
To discuss prevention strategies that can mitigate the frequency of tracheostomy-related wound complications.
Data Sources:
A systematic literature review of PubMed between 2010 and 2019.
Study Selection:
Full-text articles written in English language and studying human participants younger than 18 years.
Data Extraction:
The primary outcome was the rate of tracheostomy-related skin complications after implementation of a given intervention. Secondary outcomes included rates of accidental decannulation or other complications.
Data Synthesis:
A total of 348 studies were identified and 6 met inclusion criteria. There were 1,607 children included with interventions designed to reduce peristomal and cervical wound complications in 1,174 (73.1%). Strategies considered safe and effective included protective skin barriers, reducing prolonged pressure, and early wound identification protocols.
Conclusions:
Wound complications after pediatric tracheostomy can be reduced using a multifaceted approach by providers committed to making skin care a priority.
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