• Prophylactic tracheotomy is now justified in a wide variety of cases because of the continued improvement in techniques for doing the operation and caring for the patient. Especially in infants with respiratory difficulties, close observation permits tracheotomy to be done early, as elective surgery in the operating room, rather than as a late emergency procedure under adverse conditions.
A transverse skin incision prevents the later development of disfiguring scars. The exposure of the trachea must be done with certain precautions to avoid causing hemorrhage, spreading infection, or injuring the esophagus and laryngeal cartilages. The subsequent hygiene of the tracheostoma, the feeding of the patient, and the ultimate removal of the tracheotomy tube also demand special care.
Tracheotomy is not only necessary in certain types of respiratory obstruction or paralysis but is also lifesaving in cases of severe injury necessitating extensive surgery about the head, neck, or thorax.
Georgiade N, Maguire C, Crawford H, Pickrell K. PRACTICAL CONSIDERATIONS REGARDING TRACHEOTOMYSURGICAL ERRORS AND SAFEGUARDS. JAMA. 1956;160(11):940–942. doi:10.1001/jama.1956.02960460018005
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