Wound care management: tracheostomy and gastrostomy

Area of Science:

• Critical Care Medicine
• Interventional Procedures
• Patient Management

Background:

• Percutaneous dilatational tracheostomy (PDT) and percutaneous endoscopic gastrostomy (PEG) are common ICU procedures.
• These interventions facilitate patient care, healing, and prevent complications of prolonged intubation and malnutrition.
• Simultaneous PDT and PEG placement is frequently performed.

Purpose of the Study:

• To review current literature on post-procedural care and stoma wound management for PDT and PEG tubes.
• To provide guidance on recognizing and managing early and rare complications associated with these procedures.
• To emphasize the importance of multidisciplinary teams and standardized protocols for optimal patient care in the ICU.

Main Methods:

• Review of published literature on post-procedural care and stoma wound management.
• Inclusion of available recommendations for routine tracheostomy and PEG tube care.
• Discussion of signs, symptoms, and management of early and rare complications.

Main Results:

• Detailed discussion of common complications: hemorrhage, infection, accidental decannulation, tube obstruction, clogging, and dislodgement.
• Identification of rare, life-threatening complications.
• Emphasis on the need for operator skill in anatomy and procedural techniques.

Conclusions:

• Multidisciplinary teams are essential for effective patient care following PDT and PEG placement.
• Standardized institutional protocols are strongly encouraged to ensure consistent and safe patient management.
• This review offers state-of-the-art guidance for ICU care of patients with tracheostomies and gastrostomies.