The aim of the study was to compare conventional
tracheostomy with percutaneous dilatational
tracheostomy in patients with
inhalation burn injury. A total of 37 patients with severe
burn injuries and associated inhalation injury, underwent percutaneous
tracheostomy in our burn unit and were retrospectively compared with 22 patients who underwent conventional surgical
tracheostomy. In the first group, 25 of 37 patients and in the second group 17 of 22 patients presented with partial or full-thickness
burn injuries (or both) in the neck region. The cost of the procedure, operating time, complications, and incidence of pulmonary
infection were recorded. There were no significant perioperative complications in the percutaneous
tracheostomy group, and no patient required surgical revision or conversion to surgical
tracheostomy. In the conventional
tracheostomy group, 2 patients developed
tracheal stenosis, 1 had a
tracheoesophageal fistula, and 10 had stomal
infections. The average procedure time in the first group was 9 minutes, and in the second group it was 22 minutes. The cost of the bedside percutaneous
tracheostomy was one-fifth the cost of a conventional
tracheostomy. The incidence of pulmonary
sepsis was 45% after percutaneous
tracheostomy compared to 68% after conventional
tracheostomy. With the percutaneous technique, spontaneous closure of the stoma occurred within 1 to 3 days after removal of the
tracheostomy tube, whereas with the conventional technique it was within 5 to 7 days. Percutaneous
tracheostomy is associated with a lower complication rate and can be safely performed at the bedside. Moreover, it is faster and can be done at a lower cost than conventional open
tracheostomy.