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Tracheostomy—The horizontal tracheal incision

Published online by Cambridge University Press:  29 June 2007

I. Kato*
Affiliation:
(Kawasaki, Japan)
K. Uesugi
Affiliation:
(Kawasaki, Japan)
M. Kikuchihara
Affiliation:
(Kawasaki, Japan)
H. Iwasawa
Affiliation:
(Kawasaki, Japan)
J. Iida
Affiliation:
(Kawasaki, Japan)
K. Tsutsumi
Affiliation:
(Kawasaki, Japan)
H. Iwatake
Affiliation:
(Kawasaki, Japan)
I. Takeyama
Affiliation:
(Kawasaki, Japan)
*
Dr. I. Kato, Department of Otolaryngology, St. Marianna University School of Medicine, Miyamae, Sugao 2-16-1, 213 Kawasaki, Kanagawa, Japan

Abstract

The complication rate after emergency tracheostomy is two to five times greater than after elective procedures. One of the main causes of the high risk of complications in emergency tracheostomy appears to be the amount of time required to open the trachea. Therefore, simple and fast procedures are mandatory. We have developed a new procedure as follows: A horizontal skin incision is performed. Strap muscles are dissected and retracted laterally. A transverse cut between tracheal rings below the thyroid isthmus is performed up to membranous portion of the trachea. The cut ends of the trachea remain open naturally because of the elasticity of the trachea. Skin and tracheal cut-ends are then joined by interrupted sutures.

We have used this procedure during the past three years and have not experienced any major complications. This demonstrates the clear advantage and the more physiological nature of the procedure over various other incisions of the tracheal wall.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1990

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Footnotes

Paper presented by Dr. K. Uesugi at the 6th World Congress of Bronchoesophagology in Tokyo 15-18 October 1989.

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