Photo Credit: Uhjk
The following is a summary of “Securement of Tracheostomy Collar After Free Flap Surgery for Patients With Head and Neck Cancer,” published in the January 2025 issue of Critical Care by DeGuzman et al.
Adults with head and neck cancer undergoing microvascular free flap surgery, the traditional method of securing a tracheostomy collar with ties is contraindicated due to the risk of compressing newly vascularized tissue, yet alternative methods remained unclear, and current techniques, such as using safety pins, pose injury risks to staff.
Researchers conducted a retrospective study to identify methods of securing a tracheostomy collar that would enhance patient mobility, reduce staff injury risk, and ensure ease of use.
They collected data from staff members caring for 30 patients (n = 30) with head and neck cancer after microvascular free flap surgery, 3 tracheostomy securement models were tested, with each applied to 10 patients recovering from surgery and the staff rated each model using a 4-point Likert scale.
The results showed that the overall median score for every model was 3.5. Model 2 (collar secured to tubular bandages using binder rings) was rated more elevated than Model 3 (collar secured to tubular bandages utilizing tracheostomy ties) overall (P = .04), as well as for maintaining position during patient mobility (P = .04) and ease of part replacement (P = .01).
Investigators concluded that alternative methods for securing tracheostomy collars in patients with head and neck cancer who have undergone free flap surgery might offer safer and more effective options compared to traditional safety pin fixation.
