title: Prevention of tracheal cartilage injury with modified Griggs technique during percutaneous tracheostomy - Randomized controlled cadaver study.
abstract: BACKGROUND
  Tracheal stenosis is the most common severe late complication of percutaneous tracheostomy causing significant decrease in quality of life. Applying modified Griggs technique reduced the number of late tracheal stenoses observed in our clinical study. The aim of this study was to investigate the mechanism of this relationship.
  
  
  METHODS
  Forty-six cadavers were randomized into two groups according to the mode of intervention during 2006-2008. Traditional versus modified Griggs technique was applied in the two groups consequently. Wider incision, surgical preparation, and bidirectional forceps dilation of tracheal wall were applied in modified technique. Injured cartilages were inspected by sight and touch consequently. Age, gender, level of intervention, and number of injured tracheal cartilages were registered.
  
  
  RESULTS
  Significantly less frequent tracheal cartilage injury was observed after modified (9%) than original (91%) Griggs technique (p < 0.001). A moderate association between cartilage injury and increasing age was observed, whereas the level of intervention (p = 0.445) and to gender (p = 0.35) was not related to injury. Risk of cartilage injury decreased significantly (OR: 0.0264, 95%, CI: 0.005-0.153) with modified Griggs technique as determined in adjusted logistic regression model.
  
  
  CONCLUSIONS
  Modified Griggs technique decreased the risk of tracheal cartilage injury significantly in our cadaver study. This observation may explain the decreased number of late tracheal stenosis after application of the modified Griggs method.
authors.forename: Gábor
authors.initials: G
authors.lastname: Elő
authors.forename: László
authors.initials: L
authors.lastname: Zubek
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Hargitai
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Iványi
authors.forename: Judit
authors.initials: J
authors.lastname: Branovics
authors.forename: János
authors.initials: J
authors.lastname: Gál
keywords: Griggs technique; cadaver; percutaneous tracheostomy; tracheal cartilage injury; tracheal stenosis