Transverse Flap Tracheostomy: A Technique for Temporary Tracheostomy of Intermediate Duration

Abstract

Summary A technique is described which is particularly useful in obese or heavily muscled animals when a single lumen tracheostomy tube is used, or when mechanical ventilation through a cuffed tracheostomy tube is required. The technique assures easy access to a large tracheal stoma which facilitates cleaning and tube replacement.

A modified temporary tracheostomy in dogs: outcome and complications in 21 dogs (2012 to 2017)

“…, , Macintire et al . , Colley & Huber , Nicholson & Baines , Occhipinti & Hauptman ). Breeds predisposed to BOAS including the English bulldog, French bulldog and pug (Dupré & Heidenreich ) all have the characteristic thick neck and loose cervical skin.…”

“…, Macintire et al . ). Bulldogs with thick necks have higher tracheostomy tube dislodgement rates (Nicholson & Baines ).…”

“…The transverse tracheostomy closes when the tube is removed or dislodged and replacement of the tube can be challenging (Macintire et al . ). Human patients with obesity benefit from the H‐ shaped (with inferior and superior flaps) or the Bjork flap (with a single large inferior flap) tracheostomies to improve access to the trachea and facilitate tube management (Cipriano et al .…”

“…In thick‐necked dogs, such as those of brachycephalic breeds, this can be challenging (Macintire et al . ) and sedation before tube changing has been advised (Hedlund ). The transverse tracheostomy closes when the tube is removed or dislodged and replacement of the tube can be challenging (Macintire et al .…”

“…This technique has been reported by Macintire et al . () in combination with a transverse flap tracheostomy to ventralise the trachea. Nicholson & Baines () advocated that ventralisation of the trachea to reduce tracheal skin distance could result in a lower complication rate in cases with increased cervical tissue mass.…”