title: [Life-threatening complications after plastic tracheostomy closure. Which length of hospital stay according to clinical and forensic viewpoints is necessary?].
abstract: BACKGROUND
  Plastic tracheostomy closure represents a safe surgical method with rare but potentially life-threatening complications such as dyspnea. Because of the general tendency to reduce hospital stay, the medically necessary time of hospitalization should be evaluated.
  
  
  METHODS
  Ninety-eight patients operated in succession were examined retrospectively for extent, time, and therapeutic procedures in cases of life-threatening dyspnea. Moreover, disorders of wound healing which had to be treated surgically were analyzed.
  
  
  RESULTS
  Of 98 patients 17% (17/98) developed dyspneas, 10% (10/98) up to the 3rd postoperative day, 2% (2/98) on the 6th postoperative day, and 5% (5/98) between the 17th and 92nd postoperative days; 13% (13/98) had to be treated because of extensive disorders of wound healing, 85% (11/13) up to the 3rd day.
  
  
  CONCLUSIONS
  From the clinical and forensic viewpoint, a hospital stay for at least 3 postoperative days is necessary to record the majority of life-threatening complications after plastic tracheostomy closure.
authors.affiliation: Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde des Universitätsklinikums Hamburg-Eppendorf, Hamburg. swenzel@uke.uni-hamburg.de
authors.forename: S
authors.initials: S
authors.lastname: Wenzel
authors.forename: C
authors.initials: C
authors.lastname: Sagowski
authors.forename: W
authors.initials: W
authors.lastname: Kehrl
authors.forename: C
authors.initials: C
authors.lastname: Hessler
authors.forename: F U
authors.initials: FU
authors.lastname: Metternich
mesh_terms: D015897:Comorbidity; D018572:Disease-Free Survival; D004417:Dyspnea / Q000453:epidemiology*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013524:Surgical Flaps / Q000706:statistics & numerical data*; D013530:Surgical Wound Infection / Q000453:epidemiology*; D013536:Suture Techniques / Q000706:statistics & numerical data*; D014139:Tracheostomy / Q000706:statistics & numerical data*