Indications and early complications of standard tracheostomy

Objective: to determine the most common indications and early complications of standard tracheostomy observed in patients at combined military hospital,rawalpindi study design: prospective observational study setting: ent department,combined military hospital,rawalpindi duration: from 1 st february 2007 to 31 st december 2009 patients and methods: a series of 127 consecutive patients who had tracheostomy performed over a period of 23 month from 1 st february 2007 to 31 st december 2009 were included in the study. all the tracheostomies were performed using a standard technique. a cuffed portex tracheostomy tube was used in all cases during first and subsequent tracheostomy tube insertions. patients were followed for complications occurring in the first two weeks after the procedure. results: out of 127 patients,86 were males (67.7 %) with a male to female ratio of 2:1. the mean age was 49.3 years. elective tracheostomies were performed in 93 (73%) of these patients. head and neck surgery was indicated in 48.2% of elective cases. intubation assistance was most common indication for emergency procedures. most common complication that we recorded was wound infection (24.4%). we observed accidental decannulations in 4 patients (3.1%),false passage intubation in 6 (4.7%) and surgical emphysema in 18 (14%) of the cases. one patient died before the obstruction could be removed. conclusion: current tracheostomy technique is still associated with complications with occasional drastic consequences such as death. caution on the part of trained staff is important to avoid such incidences.