Tracheostomy healing time after decannulation

Multidiscip Respir Med. 2022 Feb 9;16(1):822. doi: 10.4081/mrm.2022.822. eCollection 2022 Jan 12.

Abstract

Background: Prolonged healing of tracheostomy after decannulation has a negative impact on respiration, hygiene, cosmetics, and social life. Even so, evidence-based observations of tracheostoma healing time are lacking. Therefore, the aim of this study was to determine tracheostomy wound healing time after decannulation.

Methods: In this prospective observational cohort study, we included 30 subjects undergoing decannulation following prolonged mechanical ventilation via tracheostomy. Our primary endpoint was tracheostomy healing time defined as time from decannulation to airtight healing. To identify any factors related to healing time, we included information about patient demographics, comorbidities, tracheostomy method, tube size, and intubation time. All subjects were observed daily until their tracheostomy wound had healed.

Results: The median tracheostomy healing time was 6.5 (1-22) days. The duration of tracheal cannulation was the only factor significantly correlated with prolonged healing (p=0.03). Four patients were subjected to recannulation shortly after decannulation due to hypercapnia, respiratory failure, secretion accumulation, or self-decannulation. All wounds achieved complete spontaneous airtight closure.

Conclusions: Duration of spontaneous tracheostomy closure after decannulation was 1-22 days, and closure time correlated with duration of cannulation.

Keywords: Tracheostomy; complication; decannulation; healing; prolonged mechanical ventilation; wound closure.

Grants and funding

Funding: This work was supported by an exploratory pre-seed grant from the Novo Nordisk Foundation.