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Reducing Pediatric Tracheostomy Wound Complications: An Evidence-Based Literature Review

ABSTRACT 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.