THE ESTABLISHMENT of a tracheostomy is a routine procedure in most patients who undergo radical surgery for extirpation of cancer of the oropharynx. Obviously the normal body mechanisms for humidification of the tracheobronchial tree are bypassed; therefore an artificial method is required to prevent drying of secretions, crusting within the trachea, and obstruction of the bronchioles which may lead to atelectasis, pneumonia, and tracheitis secca. The morbidity in these patients is due in large part to such complications. Such agents as boric acid, saline solutions, wetting agents, etc., have long been introduced into the trachea in an attempt to prevent this drying of secretions, without complete satisfaction.
In recent years, various enzymatic substances have been used in treating chronic pulmonary diseases to effect lysis of these tenacious pulmonary secretions by changing the viscosity. Armstrong and White1 demonstrated that viscous purulent exudates could be liquified by deoxyribonuclease. Sherry et al.
Sharp EH, Chambers RG. Surgical Use of Pancreatic Dornase: A Clinical Trial. JAMA. 1961;176(2):144–146. doi:10.1001/jama.1961.63040150005018
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