The usefulness of the stay suture technique in tracheostomy

Abstract

Objective: Tracheostomy tube displacement may occur at any time in the course of patient management. Although an infrequent occurrence, such displacement is potentially serious. The purpose of this study was to evaluate the advantages and complications of the stay suture technique in tracheostomy.

Study design: Prospective cohort study.

Methods: The SST involves the placement of sutures between the anterior tracheal wall and the skin in order to hasten the formation of a mature stoma. The study patients were divided into two groups. One group underwent tracheostomy with the SST (n =104), and the other group was treated with a conventional tracheostomy (n = 101). The postoperative complications for each group were then reviewed.

Results: The most common indication for tracheostomy was prolonged endotracheal intubation (79.3%), and the most common complication in each group was postoperative stoma infection. Unexpected decannulation occurred in three patients from the conventional tracheostomy group, causing death of the patients. However, the SST group did not show any occurrence of unexpected decannulation.

Conclusions: Unexpected decannulation was a fatal complication. Because this complication was not observed in any patients who underwent the SST, our study recommends use of this method as a countermeasure for unexpected decannulation.

Level of evidence: 4.

Keywords: Tracheostomy; airway; complications; sutures.