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    Wound care management: Tracheostomy and gastrostomy

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    Author
    Alsunaid, Sammar
    Holden, Van K.
    Kohli, Akshay
    Diaz, Jose
    O'Meara, Lindsay B.
    Date
    2021-08-01
    Journal
    Journal of Thoracic Disease
    Publisher
    AME Publishing Company
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.21037/jtd-2019-ipicu-13
    Abstract
    Percutaneous dilatational tracheostomy (PDT) and percutaneous endoscopic gastrostomy (PEG) tube placements are routine procedures performed in the intensive care units (ICUs). They are performed to facilitate care and promote healing. They also help prevent complications from prolonged endotracheal intubation and malnutrition. In most cases, both are performed simultaneously. Physicians performing them require knowledge of local anatomy, tissue and vascular relationships, along with advance bronchoscopy and endoscopy skills. Although PDTs and PEGs are considered relatively low-risk procedures, operators need to have the knowledge and skill to recognize and prevent adverse outcomes. Current published literature on post-procedural care and stoma wound management was reviewed. Available recommendations for the routine care of tracheostomy and PEG tubes are included in this review. Signs and symptoms of early PDT-and PEG-related complications and their management are discussed in detail. These include hemorrhage, infection, accidental decannulation, tube obstruction, clogging, and dislodgement. Rare, life-threatening complications are also discussed. Multidisciplinary teams are needed for improved patient care, and members should be aware of all pertinent care aspects and potential complications related to PDT and PEG placement. Each institute is strongly encouraged to have detailed protocols to standardize care. This review provides a state-of-the-art guidance on the care of patients with tracheostomies and gastrostomies specifically in the ICU setting. © Journal of Thoracic Disease. All rights reserved.
    Keyword
    Critical care
    Gastrostomy
    Nursing care
    Tracheostomy
    Wounds
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/16635
    ae974a485f413a2113503eed53cd6c53
    10.21037/jtd-2019-ipicu-13
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