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Related Concept Videos

Tracheostomy Decannulation01:21

Tracheostomy Decannulation

1.7K
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...
1.7K
Tracheostomy Care I: Pre-procedural Steps01:16

Tracheostomy Care I: Pre-procedural Steps

1.4K
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:
1.4K
Tracheostomy Care II: Procedure01:25

Tracheostomy Care II: Procedure

1.7K
Tracheostomy care is an essential nursing skill that involves cleaning and maintaining a tracheostomy tube to prevent infection and other complications. Here's a step-by-step guide explaining each procedure with its rationale. Note that disposable gloves are to be worn at all times and changed as often as needed to maintain a sterile work environment, and to protect both patient and healthcare worker.
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask...
1.7K
Tracheostomy: Procedure and Tubes01:28

Tracheostomy: Procedure and Tubes

3.8K
A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
3.8K
Tracheostomy Suctioning I: Pre-Procedural Steps01:26

Tracheostomy Suctioning I: Pre-Procedural Steps

2.6K
Tracheostomy suctioning is a critical procedure healthcare professionals perform to maintain a patent airway in patients with a tracheostomy tube. This procedure is necessary when secretions accumulate in the airway, causing respiratory distress. Here is a step-wise procedural guide for performing tracheostomy suctioning using an open system.
Equipment Required
First, gather all necessary equipment: a sterile suction catheter, a sterile disposable container, sterile gloves, a towel or...
2.6K
Tracheostomy Suctioning II: Procedure01:23

Tracheostomy Suctioning II: Procedure

2.1K
Tracheostomy suctioning is a vital nursing procedure that involves removing secretions from the tracheostomy tube to maintain airway patency and prevent respiratory complications. Nurses need to understand the proper technique for tracheostomy suctioning to ensure patient safety and comfort. In this guide, we will outline the step-by-step process for performing tracheostomy suctioning, including preparing the sterile field, donning personal protective equipment (PPE), lubricating and connecting...
2.1K

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Updated: Feb 17, 2026

Porcine As a Training Module for Head and Neck Microvascular Reconstruction
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Post-Operative Tracheostomy Decannulation Protocol Following Head and Neck Free Flap Reconstruction: A Prospective

William H Weir1, Samuel D Cloyd1, Kaersti L Rickels1

  • 1Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.

Head & Neck
|February 16, 2026
PubMed
Summary

A standardized tracheostomy decannulation protocol improved patient selection for early removal after head and neck reconstruction, significantly reducing emergency room returns for airway issues.

Keywords:
airway managementcappingdecannulationfree flap reconstructionpatient safetytracheostomy

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Area of Science:

  • Otolaryngology
  • Head and Neck Surgery
  • Critical Care Medicine

Background:

  • Decannulation timing after head and neck reconstruction lacks standardized assessment methods.
  • Variability in decannulation practices can impact patient outcomes and resource utilization.

Purpose of the Study:

  • To evaluate the impact of a standardized post-operative tracheostomy decannulation protocol.
  • To assess the effect on emergency room (ER) returns for airway issues within 30 days.
  • To analyze decannulation rates and patient-specific factors influencing successful decannulation.

Main Methods:

  • Prospective data collection for 114 patients undergoing free flap reconstruction with tracheostomy post-protocol implementation.
  • Comparison with a retrospective control cohort of 96 patients prior to protocol.
  • A two-tiered protocol including finger occlusion tolerance, abbreviated fiberoptic evaluation of swallowing (FEES), suction frequency, cough assessment, oxygen needs, and mental status, followed by a 24-hour capping trial.

Main Results:

  • The protocol cohort showed a trend towards higher decannulation rates before discharge (39.5% vs. 32.3%).
  • A significant reduction in 30-day ER returns for airway issues was observed in the protocol cohort (0.9% vs. 6.2%; p=0.048).
  • Anterior defects involving the genial tubercle were associated with lower decannulation rates (24.3% vs. 42.1%; p=0.017).

Conclusions:

  • Implementing a standardized decannulation protocol enhances provider confidence in patient selection for early tracheostomy removal.
  • The protocol effectively reduces emergency room revisits related to upper airway complications post-head and neck reconstruction.
  • Standardization aids in optimizing patient care pathways and resource management in head and neck surgery.