A Modification of the Initial Surgical Steps in Percutaneous Dilatational Tracheostomy

Abstract

The percutaneous dilatational method or serial dilator technique for tracheostomy was described by Ciaglia et al in 1985 1 . Since then, at least five other techniques for the procedure have been described: the Rapitrach method (1989), Griggs guide wire dilating forceps method (1990), the retrograde percutaneous trans-laryngeal tracheostomy (1997), Ciaglia Blue Rhino technique (2000) and the PercuTwist technique (2002) 2-6 . The initial surgical steps described in most methods include, after positioning of the patient and painting of the neck with an antiseptic, local infiltration of lignocaine, followed by skin incision, and thereafter, tracheal puncture and guide wire insertion.