Tracheostomy, Is It Really Innocent?

Abstract

Tracheostomy one of the oldest surgical procedures has been practiced probably for thousands years. Now, it is the most commonly performed surgical procedures in ICUs with appreciable morbidity and complications (8-45%). We aimed to investigate the histopathological changes which lead to stenosis in tracheal epithelia after the conventional tracheostomy in rabbit model. 24 male New Zealand White rabbits were randomly divided into 3 equal groups. Classic tracheostomy was carried out in 16 subjects. Group 1 which was made any surgical procedure served as control. After tracheostomy, we applied sterile saline in Group 2, Mitomycin-C (0.8 mg/ml) (MMC) in Group 3 around tracheotomy for 5 minutes. At 3 weeks after surgery, tracheas were evaluated by morphometric and histopathological examination with the inclusion of tracheal lumen diameter, number of capillary vessels, subepithelial tissue thickness, fibroblasts and inflammatory cells. There were statistically significant differences between tracheostomy and control group for tracheal lumen diameter (P=0.35), number of capillary vessels (P=0.06), subepithelial tissue thickness, fibroblasts and number of lymphocyte (p Stenosis one of the most difficult and devastating problems in airway surgery we believe to wound healing modulation may prevent scar formation and no need further surgery. Even if, there are undoubtedly many advantages of tracheostomy these must be balanced against the real risk of the procedure. As a result, tracheostomy is not an innocent procedure. In patients who underwent tracheostomy, scarring and granulation tissue formation should always be kept in mind.