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Skin tethering after dilatational percutaneous tracheostomy
H B Whittet1, D J Commins, C S Waldmann
1Otolaryngology Department, Singleton Hospital, Swansea.
Anaesthesia
|October 1, 1995
Summary
Percutaneous tracheostomy is a preferred ICU procedure. A previously unemphasized complication, skin tethering, can cause significant patient morbidity despite being primarily cosmetic.
Area of Science:
- Critical Care Medicine
- Surgical Techniques
- Patient Safety
Background:
- Percutaneous tracheostomy is a widely adopted procedure in Intensive Care Units due to its convenience and low complication rates.
- The technique involves creating a surgical opening in the trachea through the skin.
- Standard complications are well-documented, but less common issues may be overlooked.
Observation:
- Skin tethering, where the skin adheres abnormally to underlying structures, has been observed as a complication of percutaneous tracheostomy.
- This finding was not previously highlighted as a significant concern associated with the procedure.
- The cosmetic appearance is often the primary concern, but functional impact is also noted.
Findings:
- Skin tethering, while often considered cosmetic, can lead to substantial patient morbidity.
- The morbidity associated with skin tethering requires further investigation and clinical attention.
- This complication underscores the need for comprehensive assessment of all potential outcomes.
Implications:
- Clinicians should be aware of skin tethering as a potential complication of percutaneous tracheostomy.
- Further research is warranted to understand the mechanisms and long-term effects of skin tethering.
- Management strategies may need to be developed to address this complication and improve patient outcomes.