title: Gauze versus solid skin barrier for tracheostomy care: a crossover randomized clinical trial.
abstract: OBJECTIVE
  The aim of this study was to compare gauze and a solid pectin-based skin barrier to evaluate clinical outcomes and cost-effectiveness of care for tracheostomy wounds.
  
  
  METHODS
  A randomized clinical trial with crossover design was conducted to compare gauze to a solid skin barrier for management of patients with tracheostomies. The main study outcomes were skin integrity, dressing change frequency, time required for dressing changes, product costs, and nurses' satisfaction.
  
  
  METHODS
  A convenience sample was recruited from 2 medical centers in Taiwan. Using permuted block randomization, patients undergoing tracheostomy were randomly allocated to 1 of 2 groups. One group received tracheostomy care with gauze for the first 6 days and a solid pectin-based skin barrier for the following 6 days. This regimen was reversed in the second group.
  
  
  RESULTS
  Skin integrity was significantly better among patients managed with a solid skin barrier as compared to management with gauze (Z=-2.75, P= .006). No significant differences in dressing change frequency, time required for dressing changes, or product costs between the 2 groups were found. Nurses' satisfaction was significantly higher for the solid skin barrier as compared to gauze (Z=-2.31, P= .021, for group 1, and T=-1.97, P= .048, for group 2).
  
  
  CONCLUSIONS
  The use of a solid skin barrier for tracheostomy care was associated with lower occurrences of impaired skin integrity and higher satisfaction among nurses when compared to gauze.
authors.affiliation: Wen-Ling Chuang, MSN, Wound Care Specialist, Department of Nursing, Chi Mei Medical Center, Tainan, Taiwan. Wen-Pei Huang, MA, Wound Care Specialist, Department of Nursing, Chi Mei Medical Center, Tainan, Taiwan. Mei-Hsing Chen, MSN, Director, Department of Nursing, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan. I-Ping Liu, MSN, Director, Department of Nursing, Chi Mei Medical Center, Tainan, Taiwan. Wen-Liang Yu, MD, Wound Care Specialist, Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan. Chi-Chun Chin, PhD, Associate Professor, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Wen-Ling
authors.initials: WL
authors.lastname: Chuang
authors.forename: Wen-Pei
authors.initials: WP
authors.lastname: Huang
authors.forename: Mei-Hsing
authors.initials: MH
authors.lastname: Chen
authors.forename: I-Ping
authors.initials: IP
authors.lastname: Liu
authors.forename: Wen-Liang
authors.initials: WL
authors.lastname: Yu
authors.forename: Chi-Chun
authors.initials: CC
authors.lastname: Chin
mesh_terms: D001458:Bandages / Q000191:economics; D003365:Costs and Cost Analysis; D018592:Cross-Over Studies; D006801:Humans; D010368:Pectins; D012867:Skin; D014139:Tracheostomy / Q000451:nursing*; D016896:Treatment Outcome
chemical_list: D010368:Pectins