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Tracheotomy wounds are usually treated by the open method, whether the tracheotomy has been done for the removal of a neoplasm, or of a foreign body, or for dyspnea due to infection. In the presence of infection, it is unquestionably better to drain the wound, but in the absence of infection, it would be better to close the wound, provided, of course, that the cause of the dyspnea has been removed.
Immediate closure lessens the danger from pneumonia and from infection occurring in the wound itself, it shortens the convalescence and reduces to the minimum the deformity due to the scar; the latter being of particular consequence in females.
I firmly believe that the mortality in these cases may be lessened by immediate closure of the wound, and it seems to me that the morbidity may be decreased by adopting this method; the deformity certainly is lessened thereby.
PORTER MF. IMMEDIATE CLOSURE OF TRACHEOTOMY WOUNDS. JAMA. 1905;XLIV(14):1115–1116. doi:10.1001/jama.1905.92500410037003a
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