Prophylactic tracheostomy in aged and poor risk general surgical patients.

The most common postoperative complications are those involving respiration, and they are especially dangerous to patients classified as poor risks because of age or other handicaps. Among the 11 patients whose histories are given, some who were nearly moribund from respiratory difficulties were saved by tracheostomy; others made good recoveries from major surgery under conditions that would have been hopeless without the help afforded by prophylactic tracheostomy. If this possibility is foreseen, an orderly procedure can be carried out in the operating room instead of desperate measures on the ward. Scrupulous care of the tracheostomy is essential; this includes aseptic precautions, humidification of the inhaled air or oxygen, and the systematic but gentle use of suction to aspirate accumulating mucus.