The first 72 hours of care for patients who have undergone microvascular free flap reconstruction for head and neck cancer is crucial for preventing tissue hypoxia and necrosis. Many of these patients have a tracheostomy placed, and traditional methods of securing the tracheostomy may cause circumferential neck restriction.

DeGuzman and colleagues explored the use of 3 alternative methods of tracheostomy securement to maximize patient mobility and staff ease of use: (1) washcloths with binder rings (connecting to the tracheostomy collar), (2) tubular bandages with binder rings, and (3) tubular bandages with tracheostomy ties. They found

  • Tubular bandages with binder rings (option 2) performed the best, were perceived as more stable during ambulation, and were least troublesome for the nursing staff.

  • Participant feedback revealed that none of the 3 securement methods were considered entirely stable during ambulation.

Although more testing is warranted, findings show that alternative methods of tracheostomy securement are...

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