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Related Concept Videos

Tracheostomy Decannulation01:21

Tracheostomy Decannulation

115
Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
115
Tracheostomy Care I: Pre-procedural Steps01:16

Tracheostomy Care I: Pre-procedural Steps

136
A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
The equipment necessary for tracheostomy care includes:
136
Ostomy Care01:24

Ostomy Care

224
Introduction
An ostomy is a surgical procedure that creates an artificial opening from the intestines to the outside of the body, allowing for the rerouting of effluent. This opening is known as a stoma. A stoma usually protrudes above the skin surface, appearing pink or red, moist, and round, and it lacks nerve sensations.
There are different types of ostomies, including colostomies, ileostomies, and urostomies:
224

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Related Experiment Video

Updated: Jun 8, 2025

A Case Series of Successful Abdominal Closure Utilizing a Novel Technique Combining a Mechanical Closure System with a Biologic Xenograft that Accelerates Wound Healing
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Timing of Stoma Closure in Neonates: the ToSCiN mixed-methods study.

Nick Lansdale1,2, Kerry Woolfall3, Elizabeth Deja3

  • 1Department of Paediatric and Neonatal Surgery, Royal Manchester Children's Hospital, Manchester, UK.

Health Technology Assessment (Winchester, England)
|November 2, 2024
PubMed
Summary
This summary is machine-generated.

Conducting a clinical trial on early versus late stoma closure in neonates is feasible. The study identified challenges and recommendations for trial design, ensuring sufficient eligible infants in the UK.

Keywords:
ENTEROSTOMYFEASIBILITY STUDIESINFANTNECROTISING ENTEROCOLITISNEWBORNSURGICAL STOMAS

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Area of Science:

  • Neonatal surgery
  • Clinical trial feasibility
  • Stoma management

Background:

  • Neonates undergoing emergency abdominal surgery often require stomas, necessitating a second operation for closure.
  • The optimal timing for stoma closure in neonates is currently unclear and requires investigation through a randomized controlled trial.
  • Such a trial presents significant challenges in terms of design and execution.

Purpose of the Study:

  • To determine the feasibility of conducting a clinical trial comparing early versus late stoma closure in neonates.
  • To identify potential challenges and facilitators for trial implementation.
  • To gather insights from clinicians and parents regarding optimal trial parameters.

Main Methods:

  • A mixed-methods approach was employed, including a clinician survey, prospective observational cohort study, parent interviews, and focus groups.
  • Data were collected from specialist neonatal surgical centers across the United Kingdom.
  • Analysis of existing clinical databases was conducted to estimate the eligible patient population.

Main Results:

  • A survey of 166 professionals indicated that 6 weeks was the most common target for stoma closure, but significant variation exists.
  • The prospective cohort study enrolled 56 infants, primarily preterm infants with necrotizing enterocolitis or intestinal perforation.
  • Clinicians and parents highlighted the need for flexibility in trial arms regarding stoma closure timing, especially for extremely preterm infants.

Conclusions:

  • A randomized controlled trial comparing early and late stoma closure in neonates is feasible and deemed important by stakeholders.
  • Sufficient eligible infants exist in the UK to support such a trial.
  • Key challenges include equipoise, managing extremely preterm infants, and logistical issues, which can be addressed through flexible trial design and clear communication.