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2023, Number 2

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Med Crit 2023; 37 (2)

Experience in 24 patients with vertical incision tracheostomy technique for a lowing visibility for protection security equipment in COVID intensive care respiratory

Medina LJL, Valencia RA, Barriga FP, Luquin SJC, Barrera VJL, Sánchez PM
Full text How to cite this article 10.35366/110438

DOI

DOI: 10.35366/110438
URL: https://dx.doi.org/10.35366/110438

Language: Spanish
References: 7
Page: 69-71
PDF size: 173.44 Kb.


Key words:

incision, vertical tracheotomy, surgical time, transoperative bleeding, coagulation time.

ABSTRACT

The use of personal protective equipment, especially eye protection, limits vision when performing surgical procedures in the COVID area, these limitations force us to make modifications to usual procedures, on this occasion a modification is made to the usual incision of the procedure open tracheostomy. A modification described in previous bibliographies was made, modifying the orientation of the incision, changing the usual orientation of the horizontal incision to a vertical incision, preserving the rest of the technique and dissection of the usual planes as well as placement of the cannula. The modification of the technique aims to reduce the risk of complications caused by poor vision due to personal protective equipment, within these complications to reduce the risk of injury to large vessels that by anatomy are in the anatomical site of the procedure, improve the vision conditions as it is a single muscle and aponeurotic dissection plane, reduce transoperative bleeding by incising in the midline, thereby reducing the risk of complications, improving the operator's vision conditions and reducing the risk of infection of personal health.


REFERENCES

  1. Kwak PE, Connors JR, Benedict PA, Timen MR, Wang B, Zhang Y, et al. Early outcomes from early tracheostomy for patients with COVID-19. JAMA Otolaryngol Head Neck Surg. 2021;147(3):239-244.

  2. Kaushal D, Goyal S, Nair NP, Soni K, Choudhury B, Kumari M, et al. Tips and pearls for tracheostomy during the Covid-19 pandemic. Int Arch Otorhinolaryngol. 2021;25(3):e459-e462. doi: 10.1055/s-0041-1731723.

  3. Mandal A, Nandi S, Chhebbi M, Basu A, Ray M. A systematic review on tracheostomy in COVID-19 patients: current guidelines and safety measures. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 2):2738-2742. doi: 10.1007/s12070-020-02152-w.

  4. Ji Y, Fang Y, Cheng B, Li L, Fang X. Tracheostomy timing and clinical outcomes in ventilated COVID-19 patients: a systematic review and meta-analysis. Crit Care. 2022;26(1):40. doi: 10.1186/s13054-022-03904-6.

  5. Nadeem R, Zahra AN, Hassan M, Parvez Y, Gundawar N, Hussein MAM, et al. Prevalence and timing of tracheostomy and its impact on clinical outcomes in COVID-19 pneumonia patients in Dubai hospital. Dubai Medical Journal. 2021;4(2):151-155. doi: 10.1159/000515209.

  6. COVID-19: considerations for optimum surgical team protection before, during and after operation. Int J Res Orthop. 2020;6(4):868-872. doi: 10.18203/issn.2455-4510.intjresorthop20202702.

  7. Ellison EC, Milton R. Zollinger's atlas of surgical operations. New York: McGraw-Hill Education; 2022.




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Med Crit. 2023;37