Early postoperative complications following tracheotomy: Does suturing technique influence outcomes?

Area of Science:

• Otolaryngology-Head and Neck Surgery
• Surgical Techniques
• Patient Outcomes

Background:

• Tracheotomy is a common procedure with no consensus on suturing techniques impacting complications.
• Stay sutures and Bjork flaps are frequently used to secure the tracheal incision for recannulation.

Purpose of the Study:

• To evaluate the effect of suturing techniques (Bjork flap vs. stay sutures) on postoperative complications and patient outcomes in tracheotomy.
• To determine if specific suturing methods are associated with adverse events.

Main Methods:

• Retrospective cohort study of 518 tracheotomies performed between May 2014 and August 2020.
• Analysis of patient demographics, comorbidities, indication for tracheostomy, and postoperative complications.
• Comparison of Bjork flap (317 cases) versus stay sutures (201 cases).

Main Results:

• No significant difference in tracheal bleeding, infection, mucus plugging, pneumothorax, or false passage between Bjork flap and stay suture techniques.
• One mortality occurred post-decannulation during the study period.
• Neither suturing technique demonstrated superiority in preventing common postoperative complications.

Conclusions:

• The method used to secure a tracheostomy stoma does not appear to be associated with adverse outcomes.
• Patient's underlying medical comorbidities and the reasons for tracheostomy are likely more critical factors influencing postoperative results.