Complications of open surgical tracheostomy and their management-our experience
Introduction
Tracheostomy is the surgical procedure to create an artificial opening in the trachea to bypass the obstructed airway above it. History reveals that it is an oldest surgical procedure dating back 3600 B.C.E. in Egypt(1). It has under gone numerous modifications during the past millennia. The first elective tracheostomy was done in AD 100 by Asclepiad’s of Bithynia and the described by Galen in AD131(2). In early AD 1600 it was an established procedure for airway obstruction. The evolution of tracheostomy can be summarized into five stages. The first and longest period (covering roughly 3,000 years from 1500 BC to 1500 AD) begins with references to incisions into the …show more content…
In 1932 Wilson suggested its prophylactic and therapeutic use in poliomyelitis. Tracheostomy was then recommended for a large variety of indications apart from obstructive causes... Finally, the era starting in 1965 till the present period came as a period of rationalization. Complications, indications and interrelation with endotracheal intubation are clearly outlined(3). It started as just making an opening in the trachea to proper placement of metallic tube to plastic tubes. Otolaryngologists dominated the surgical scene in open surgical tracheostomy, then arrived the era of percutaneous dilatational tracheostomy and its subsequent modification done by various other specialties(4). Apart from very rare instances the indication of tracheostomy for upper airway obstruction and reduced dead space are now the part of history (5).Current practice of tracheostomy is that it is commonly performed in critically ill patients admitted in intensive care unit(ICU) for prolonged mechanical ventilation. . The objectives of tracheostomy in intensive care unit are early weaning from ventilator, decrease need of sedation,
Introduction
Tracheostomy is the surgical procedure to create an artificial opening in the trachea to bypass the obstructed airway above it. History reveals that it is an oldest surgical procedure dating back 3600 B.C.E. in Egypt(1). It has under gone numerous modifications during the past millennia. The first elective tracheostomy was done in AD 100 by Asclepiad’s of Bithynia and the described by Galen in AD131(2). In early AD 1600 it was an established procedure for airway obstruction. The evolution of tracheostomy can be summarized into five stages. The first and longest period (covering roughly 3,000 years from 1500 BC to 1500 AD) begins with references to incisions into the …show more content…
In 1932 Wilson suggested its prophylactic and therapeutic use in poliomyelitis. Tracheostomy was then recommended for a large variety of indications apart from obstructive causes... Finally, the era starting in 1965 till the present period came as a period of rationalization. Complications, indications and interrelation with endotracheal intubation are clearly outlined(3). It started as just making an opening in the trachea to proper placement of metallic tube to plastic tubes. Otolaryngologists dominated the surgical scene in open surgical tracheostomy, then arrived the era of percutaneous dilatational tracheostomy and its subsequent modification done by various other specialties(4). Apart from very rare instances the indication of tracheostomy for upper airway obstruction and reduced dead space are now the part of history (5).Current practice of tracheostomy is that it is commonly performed in critically ill patients admitted in intensive care unit(ICU) for prolonged mechanical ventilation. . The objectives of tracheostomy in intensive care unit are early weaning from ventilator, decrease need of sedation,