Impact of stoma maturation on pediatric tracheostomy-related complications.
OBJECTIVE
To assess the impact of stoma maturation on pediatric tracheostomy-related complications and to report the incidence of pediatric tracheostomy-related complications.


METHODS
Retrospective medical chart review and data analysis.


METHODS
Tertiary care children's hospital.


METHODS
A total of 172 consecutive patients who underwent tracheotomy during a 4-year period.


METHODS
Tracheotomy with or without stoma maturation at the time of surgery was performed by 8 pediatric otolaryngologists. Stoma maturation was based solely on individual surgeon preference, not on patient factors.


METHODS
Early and late tracheostomy-related complications; correlation between stoma maturation and complication rate.


RESULTS
The patients' mean (SD) age was 4.9 (6.6) years, with a mean follow-up of 35.4 (24.5) months. Of 156 patients for whom stoma maturation data were available, 48 (30.8%) underwent stoma maturation and 108 (69.2%) did not. Nineteen of 172 patients (11.0%) had an early complication (within the first 7 days), including accidental decannulation, bleeding, false tract, pneumonia, and tracheitis. Late complications included suprastomal tracheal granulation tissue (48.8%), tracheitis (48.8%), peristomal granulation tissue (26.7%), accidental decannulation (11.6%), and mucus plugging (9.9%). Among the 62 patients (36.0%) who were decannulated, 23 of 62 (37.1%) developed a persistent tracheocutaneous fistula. Younger patients had a higher rate of suprastomal granulation tissue, tracheitis, tracheocutaneous fistula, and repeated surgical procedures (P < .05). Patients with stoma maturation were incidentally older than patients without stoma maturation (P < .05). When corrected for age, stoma maturation did not have an impact on the incidence of any of the tracheostomy-related complications.


CONCLUSIONS
There was no relationship between stoma maturation and tracheostomy-related complications, including rate of tracheocutaneous fistula and development of granulation tissue.
Colman
Kathryn L
KL
Division of Pediatric Otolaryngology, Department of Otolaryngology, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15201, USA.
Mandell
David L
DL
Simons
Jeffrey P
JP
D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014139:Tracheostomy; D055815:Young Adult