A randomized controlled trial of Velcro versus standard twill ties following pediatric tracheotomy

Catherine K. Hart, Kareem O. Tawfik, Jareen Meinzen-Derr, John Drew Prosser, Cheryl Brumbaugh, Amy Myer, Jonette A. Ward, Alessandro de Alarcon

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives/Hypothesis: Tracheotomy is a common procedure. A reliable method of securing the tracheotomy tube is essential to minimize accidental decannulation. However, skin breakdown has been reported in ∼30% of patients. We sought to evaluate rates of skin-related complications and accidental decannulation with the use of Velcro ties compared to twill ties. Study Design: A nonblinded, randomized controlled trial comparing Velcro versus twill ties in patients undergoing tracheotomy between July 1, 2014 and January 31, 2016. Methods: Patients ≤21 years of age were recruited and randomized to receive either Velcro or twill ties. The primary outcome measure was skin-related complications. The secondary outcome measure was accidental decannulation. Outcome measures were followed through postoperative day 5. Results: Ninety-three patients were eligible, and 63 were enrolled. No patients were withdrawn. Fifty-seven patients were included in the analysis. Twenty-seven (47.4%) received Velcro, and 30 (52.6%) received twill. Five enrolled patients did not undergo tracheotomy (one Velcro, four twill). One was diagnosed with a genetic skin condition after enrollment but prior to undergoing tracheotomy. Patient characteristics were similar between groups. No significant differences were found with respect to skin-related complications (P =.59). Six patients (20%) with twill ties required early tie change compared to two (7.4%) with Velcro ties (P =.5). Two accidental decannulations occurred in the twill group compared to one in the Velcro group (P = 1.0). Conclusions: Our study demonstrated no differences in skin-related complications or accidental decannulation between Velcro and twill tracheotomy ties in the immediate postoperative period following tracheotomy. Our study suggests that Velcro ties are a viable alternative to twill ties. Level of Evidence: 1b Laryngoscope, 127:1996–2001, 2017.

Original languageEnglish (US)
Pages (from-to)1996-2001
Number of pages6
JournalLaryngoscope
Volume127
Issue number9
DOIs
StatePublished - Sep 1 2017

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Tracheotomy
Randomized Controlled Trials
Pediatrics
Skin
Outcome Assessment (Health Care)
Laryngoscopes
Postoperative Period

Keywords

  • Pediatric airway
  • evidence based medicine
  • trachea

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Hart, C. K., Tawfik, K. O., Meinzen-Derr, J., Prosser, J. D., Brumbaugh, C., Myer, A., ... de Alarcon, A. (2017). A randomized controlled trial of Velcro versus standard twill ties following pediatric tracheotomy. Laryngoscope, 127(9), 1996-2001. https://doi.org/10.1002/lary.26608

A randomized controlled trial of Velcro versus standard twill ties following pediatric tracheotomy. / Hart, Catherine K.; Tawfik, Kareem O.; Meinzen-Derr, Jareen; Prosser, John Drew; Brumbaugh, Cheryl; Myer, Amy; Ward, Jonette A.; de Alarcon, Alessandro.

In: Laryngoscope, Vol. 127, No. 9, 01.09.2017, p. 1996-2001.

Research output: Contribution to journalArticle

Hart, CK, Tawfik, KO, Meinzen-Derr, J, Prosser, JD, Brumbaugh, C, Myer, A, Ward, JA & de Alarcon, A 2017, 'A randomized controlled trial of Velcro versus standard twill ties following pediatric tracheotomy', Laryngoscope, vol. 127, no. 9, pp. 1996-2001. https://doi.org/10.1002/lary.26608
Hart, Catherine K. ; Tawfik, Kareem O. ; Meinzen-Derr, Jareen ; Prosser, John Drew ; Brumbaugh, Cheryl ; Myer, Amy ; Ward, Jonette A. ; de Alarcon, Alessandro. / A randomized controlled trial of Velcro versus standard twill ties following pediatric tracheotomy. In: Laryngoscope. 2017 ; Vol. 127, No. 9. pp. 1996-2001.
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abstract = "Objectives/Hypothesis: Tracheotomy is a common procedure. A reliable method of securing the tracheotomy tube is essential to minimize accidental decannulation. However, skin breakdown has been reported in ∼30{\%} of patients. We sought to evaluate rates of skin-related complications and accidental decannulation with the use of Velcro ties compared to twill ties. Study Design: A nonblinded, randomized controlled trial comparing Velcro versus twill ties in patients undergoing tracheotomy between July 1, 2014 and January 31, 2016. Methods: Patients ≤21 years of age were recruited and randomized to receive either Velcro or twill ties. The primary outcome measure was skin-related complications. The secondary outcome measure was accidental decannulation. Outcome measures were followed through postoperative day 5. Results: Ninety-three patients were eligible, and 63 were enrolled. No patients were withdrawn. Fifty-seven patients were included in the analysis. Twenty-seven (47.4{\%}) received Velcro, and 30 (52.6{\%}) received twill. Five enrolled patients did not undergo tracheotomy (one Velcro, four twill). One was diagnosed with a genetic skin condition after enrollment but prior to undergoing tracheotomy. Patient characteristics were similar between groups. No significant differences were found with respect to skin-related complications (P =.59). Six patients (20{\%}) with twill ties required early tie change compared to two (7.4{\%}) with Velcro ties (P =.5). Two accidental decannulations occurred in the twill group compared to one in the Velcro group (P = 1.0). Conclusions: Our study demonstrated no differences in skin-related complications or accidental decannulation between Velcro and twill tracheotomy ties in the immediate postoperative period following tracheotomy. Our study suggests that Velcro ties are a viable alternative to twill ties. Level of Evidence: 1b Laryngoscope, 127:1996–2001, 2017.",
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