Shiv Thakre
Changes to the airway management procedure for patients undergoing major head and neck reconstructive surgery in our department were brought about by improved expertise with performing percutaneous tracheostomies during the COVID-19 epidemic. In place of the formerly preferred surgical tracheostomy, the majority of patients now undergo a percutaneous tracheostomy. This study's objective was to assess our experience with percutaneous tracheostomies while contrasting complication rates with those of surgical tracheostomies carried out in comparable circumstances. Between June 2020 and November 2021, all consecutive patients undergoing free flap reconstructive surgery for head and neck cancer were included, with 56 of them receiving a percutaneous tracheostomy. Age, BMI, concomitant conditions, complications, and data from 56 surgical tracheostomies performed on the same patients before the COVID-19 epidemic were also compared. Adjustments in protocol that follow the rate of complications were slightly lower in the percutaneous group (28.57% vs. 30.35%) than in the surgical tracheostomy group. Based on the analysis of the 16 patients in the percutaneous group who had issues, selection criteria for future percutaneous tracheostomy recipients were developed. These criteria take into account things like BMI, bleeding risk, and placement deformities. The COVID-19 epidemic has provided healthcare workers with a wealth of learning opportunities that will impact the way we practise. In our unit, this has required changing the standard tracheostomy technique used for intraoperative and postoperative airway care in major head and neck reconstruction surgery.
KeywordsTracheostomy; Cancer; Head and neck; Free flap reconstruction; Covid-19
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