Characterization of patients with bacterial tracheitis after head and neck reconstruction using flaps at a...

Tracheostomy is common in head and neck reconstructive surgeries and is associated with bacterial tracheitis. However, the influence of additional risk factors on the development of this complication remains unclear. This study aimed to estimate the incidence of bacterial tracheitis and describe associated factors in patients treated at a high-complexity center in Bogotá, Colombia.

A retrospective observational cohort study was conducted at a fourth-level hospital in Bogotá between March 2023 and July 2024. Adult patients with head and neck cancer who underwent resection, flap reconstruction, and open or percutaneous tracheostomy with at least one month follow-up were included. Data were obtained from medical records, analyzed using SPSS v.31, and reported with an exploratory analysis.The study was approved by the institutional ethics committee.

Among 24 patients undergoing head and neck oncologic reconstruction, bacterial tracheitis occurred in 45.8% of cases. The condition was more frequent after open tracheostomy and among patients with delayed cannula replacement, although these differences were not statistically significant. Klebsiella pneumoniae was the predominant isolated microorganism. Patients with tracheitis had longer ICU and hospital stays, and sepsis was significantly associated with its occurrence (p = 0.031). In contrast, more frequent stoma care was associated with a lower incidence of tracheitis (p = 0.033).

Bacterial tracheitis was a frequent complication in patients undergoing head and neck free flap reconstruction with tracheostomy. More frequent stoma care may play a protective role, although larger prospective studies are needed to better identify associated risk factors and preventive strategies.