Impact of intraoperative wound dressing on post-tracheostomy pressure injuries

Area of Science:

• Pediatric Surgery
• Wound Care
• Healthcare Improvement

Background:

• Tracheostomy procedures carry a risk of skin breakdown.
• Existing protocols may not adequately prevent post-tracheostomy skin complications.
• A standardized, team-based approach is needed to improve patient outcomes.

Purpose of the Study:

• To evaluate the effectiveness of a standardized intraoperative dressing and nursing wound care protocol.
• To reduce the incidence of tracheostomy-related skin breakdown in pediatric patients.
• To implement a team-based approach for optimizing tracheostomy care.

Main Methods:

• Prospective data collection on pediatric tracheostomy outcomes.
• Implementation of standardized intraoperative wound dressings.
• Establishment of standardized nursing wound care bundles.
• Comparison of outcomes before and after intervention.

Main Results:

• Pre-intervention, the incidence of skin breakdown within the first week was 52%.
• Post-intervention, the incidence of skin breakdown decreased to 6.1%.
• The intervention group included patients who received both intraoperative dressings and nursing care bundles.

Conclusions:

• The integrated approach of intraoperative dressings and nursing care bundles is highly effective.
• This standardized protocol significantly minimizes skin breakdown in the first week post-tracheostomy for children aged 0-12.
• The team-based strategy demonstrates a near-elimination of a common tracheostomy complication.