S Wenzel1, C Sagowski, W Kehrl, C Hessler, F U Metternich. 1. Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde des Universitätsklinikums Hamburg-Eppendorf, Hamburg. swenzel@uke.uni-hamburg.de
Abstract
BACKGROUND: Plastic tracheostomy closure represents a safe surgical method with rare but potentially life-threatening complications such as dyspnea. Because of the general tendency to reduce hospital stay, the medically necessary time of hospitalization should be evaluated. METHODS: Ninety-eight patients operated in succession were examined retrospectively for extent, time, and therapeutic procedures in cases of life-threatening dyspnea. Moreover, disorders of wound healing which had to be treated surgically were analyzed. RESULTS: Of 98 patients 17% (17/98) developed dyspneas, 10% (10/98) up to the 3rd postoperative day, 2% (2/98) on the 6th postoperative day, and 5% (5/98) between the 17th and 92nd postoperative days; 13% (13/98) had to be treated because of extensive disorders of wound healing, 85% (11/13) up to the 3rd day. CONCLUSION: From the clinical and forensic viewpoint, a hospital stay for at least 3 postoperative days is necessary to record the majority of life-threatening complications after plastic tracheostomy closure.
BACKGROUND: Plastic tracheostomy closure represents a safe surgical method with rare but potentially life-threatening complications such as dyspnea. Because of the general tendency to reduce hospital stay, the medically necessary time of hospitalization should be evaluated. METHODS: Ninety-eight patients operated in succession were examined retrospectively for extent, time, and therapeutic procedures in cases of life-threatening dyspnea. Moreover, disorders of wound healing which had to be treated surgically were analyzed. RESULTS: Of 98 patients 17% (17/98) developed dyspneas, 10% (10/98) up to the 3rd postoperative day, 2% (2/98) on the 6th postoperative day, and 5% (5/98) between the 17th and 92nd postoperative days; 13% (13/98) had to be treated because of extensive disorders of wound healing, 85% (11/13) up to the 3rd day. CONCLUSION: From the clinical and forensic viewpoint, a hospital stay for at least 3 postoperative days is necessary to record the majority of life-threatening complications after plastic tracheostomy closure.