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barriers, breakdown, pediatrics, pressure, skin, tracheostomy, wound care, wound complications



  1. Baker, Lindsay R. RN
  2. Chorney, Stephen R. MD, MPH


OBJECTIVE: To discuss prevention strategies that can mitigate the frequency of tracheostomy-related wound complications.


DATA SOURCES: A systematic literature review of PubMed between 2010 and 2019.


STUDY SELECTION: Full-text articles written in English language and studying human participants younger than 18 years.


DATA EXTRACTION: The primary outcome was the rate of tracheostomy-related skin complications after implementation of a given intervention. Secondary outcomes included rates of accidental decannulation or other complications.


DATA SYNTHESIS: A total of 348 studies were identified and 6 met inclusion criteria. There were 1,607 children included with interventions designed to reduce peristomal and cervical wound complications in 1,174 (73.1%). Strategies considered safe and effective included protective skin barriers, reducing prolonged pressure, and early wound identification protocols.


CONCLUSIONS: Wound complications after pediatric tracheostomy can be reduced using a multifaceted approach by providers committed to making skin care a priority.