Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-27T15:22:31.207Z Has data issue: false hasContentIssue false
  • English
  • Français

Securing a tracheostomy when circumferential ties may compromise flap perfusion: the ‘epaulette’ technique

Published online by Cambridge University Press:  08 January 2010

P Loizou ,
P A Tierney  and
J Savage
P Loizou*
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, Southmead Hospital, Bristol, UK
P A Tierney
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, Southmead Hospital, Bristol, UK
J Savage
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, Southmead Hospital, Bristol, UK
*
Address for correspondence: Mr Peter Loizou, 14 Muller House, Ashley Down Road, Bristol BS7 9DA, UK. E-mail: p_loizou@hotmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

The use of free flaps in head and neck reconstruction raises the question of how to adequately fix a tracheostomy tube without causing local pressure to the vascular anastomosis. We describe a previously unreported technique of securing a tracheostomy tube in the immediate and early post-operative period without vascular compromise of the free flap, using the ‘epaulette’ technique. We undertook a PubMed literature search for articles describing similar methods of securing a tracheostomy tube in patients with head and neck free flaps, but found none. In our experience of using this method, we encountered no compromised flaps or unplanned extubations. We believe the epaulette technique to be an easy and safe method of securing a tracheostomy tube whilst simultaneously avoiding any local pressure effect on the free flap vessels and anastomosis.

Keywords

TracheostomyLarynxSurgical Flaps
Type
Short Communications
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 6 , June 2010 , pp. 666 - 667
Copyright
Copyright © JLO (1984) Limited 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Nahabedian, MY, Singh, N, Deune, EG, Silverman, R, Tufaro, AP. Recipient vessel analysis for microvascular reconstruction of the head and neck. Ann Plast Surg 2004;52:148–55CrossRefGoogle ScholarPubMed
2 Ross, G, Ang, E, Rik, SW, Golger, A, Lannon, D, Addison, P et al. Which venous system to choose for anastomosis in head and neck reconstructions? Ann Plast Surg 2008;61:396–8CrossRefGoogle ScholarPubMed
3 Frick, A, Baumeister, RG, Menger, MD, Vollmar, B, Wohllaib, U, Wiebecke, B. Secondary ischaemia in experimental free flaps – treatment by long acting prostacyclin analogues. Br J Plast Surg 1999;52:392–8CrossRefGoogle ScholarPubMed
4 de Weerd, L, Mercer, J, Setsa, LB. Intraoperative dynamic infrared thermography and free-flap surgery. Ann Plast Surg 2006;57:279–84CrossRefGoogle ScholarPubMed