title: Surgical technique affects the risk for tracheostoma-related complications in post-ICU patients.
abstract: CONCLUSIONS
  This study provides evidence that the surgical technique used for tracheotomy influences the risk of tracheostomy-related complications. techniques resulting in an epithelialized tracheostoma seem to minimize the risk.
  
  
  OBJECTIVE
  Tracheotomies are frequently performed procedures in critically ill patients requiring long-term ventilation. Hence, we undertook a study to evaluate factors for tracheostomy-related complications among patients with a persisting stoma after critical care.
  
  
  METHODS
  The patients underwent endoscopic examination of the tracheostoma, larynx, and trachea. The intensive care units (ICUs) were contacted with a questionnaire about the patient's diagnosis, the indication for the tracheotomy, the date of the tracheotomy, and the method of the tracheotomy procedure.
  
  
  RESULTS
  A total of 170 patients were included in this study. In all, 57.6% of the patients had unstable tracheostomas, a stenosis of the tracheal lumen above the stoma was encountered in 48.2% (G I, <50% of the lumen = 27.6% and G II, >50% of the lumen = 20.6%), and below the stoma in 3.5% of the patients. A significant association was found between severe suprastomal stenosis, tracheostoma instability and the use of dilatational tracheotomy (DT) (p<0.001). A malacia of the trachea was significantly more common among female patients (p < 0.010).
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, University of Tuebingen, Tuebingen, Germany. assen.koitschev@med.uni-tuebingen.de
authors.forename: Assen
authors.initials: A
authors.lastname: Koitschev
authors.forename: Christian
authors.initials: C
authors.lastname: Simon
authors.forename: Gunnar
authors.initials: G
authors.lastname: Blumenstock
authors.forename: Heike
authors.initials: H
authors.lastname: Mach
authors.forename: Sylke
authors.initials: S
authors.lastname: Graumueller
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D013043:Specialties, Surgical; D014139:Tracheostomy / Q000009:adverse effects* / Q000379:methods