Bitners Anna C, Burton William B, Yang Christina J
Albert Einstein College of Medicine, United States.
Albert Einstein College of Medicine, United States; Montefiore Medical Center and Children's Hospital at Montefiore, Department of Otorhinolaryngology-Head & Neck Surgery, United States.
Int J Pediatr Otorhinolaryngol. 2019 Jan;116:192-195. doi: 10.1016/j.ijporl.2018.10.022. Epub 2018 Oct 16.
To compare the rates of skin-related complications and accidental decannulation in pediatric patients who received Velcro ties versus twill ties during the early postoperative period following tracheotomy. The rates of skin-related complications and accidental decannulation in patients with Velcro ties was hypothesized to differ from those in patients with twill ties.
Medical records of 109 patients ≤18 years old who underwent elective tracheotomy were reviewed: 70 received twill ties and 39 received Velcro ties. Patients were followed for the first seven postoperative days. The primary outcome was skin-related complications, which were further categorized into mild (irritation) and severe (breakdown). The secondary outcome was accidental decannulation. Rates of skin-related complication and accidental decannulation were compared across the two groups using chi-square analysis.
Skin irritation occurred in 32 patients (45.7%) with twill ties and 10 patients (25.6%) with Velcro. Skin breakdown occurred in 20 patients (28.6%) with twill ties and 6 patients (15.4%) with Velcro. There were no accidental decannulation events. The use of Velcro ties was associated with a decreased rate of skin irritation (OR: 0.41; 95% CI: 0.17-0.97; P = 0.039).
The use of Velcro ties was associated with a decrease in the rate of skin irritation. There were no accidental decannulation events. These findings support the use of Velcro ties at the time of pediatric tracheotomy placement.
比较气管切开术后早期使用尼龙搭扣带与斜纹布带的儿科患者皮肤相关并发症及意外脱管的发生率。假设使用尼龙搭扣带患者的皮肤相关并发症及意外脱管发生率与使用斜纹布带的患者不同。
回顾了109例年龄≤18岁接受择期气管切开术患者的病历：70例使用斜纹布带，39例使用尼龙搭扣带。对患者术后前7天进行随访。主要结局为皮肤相关并发症，进一步分为轻度（刺激）和重度（破损）。次要结局为意外脱管。采用卡方分析比较两组皮肤相关并发症及意外脱管的发生率。
使用斜纹布带的32例患者（45.7%）出现皮肤刺激，使用尼龙搭扣带的10例患者（占25.6%）出现皮肤刺激。使用斜纹布带的20例患者（28.6%）出现皮肤破损，使用尼龙搭扣带的6例患者（15.4%）出现皮肤破损。未发生意外脱管事件。使用尼龙搭扣带与皮肤刺激发生率降低相关（比值比：0.41；95%置信区间：0.17 - 0.97；P = 0.039）。
使用尼龙搭扣带与皮肤刺激发生率降低相关。未发生意外脱管事件。这些发现支持在小儿气管切开术时使用尼龙搭扣带。
