Tracheal Stoma Closure and Healing Time in a Post-Acute Setting.

Abstract

Background: Complications can arise after removal of tracheostomies, including delayed or failed spontaneous closure. Little is known about the healing time after decannulation, especially for decannulation that occurs outside of the acute-care setting. This study aimed to establish the average time required for stoma closure after decannulation in an in-patient rehabilitation setting and explores patient factors that may impact healing time. Methods: In this prospective observational study, clinicians measured and photographed the stoma on decannulation, every 8 h until initial stoma closure, and every 24 h until complete healing of the skin over the stoma site. Additional data, including personal characteristics, medical diagnoses, and medications taken, were collected through medical record review and participant self-report. Results: A total of: 104 sets of data were included in the analysis. The median (interquartile range [IQR]) cannulation time in this sample was 54 (35-70) d. The median (IQR) days to stoma closure were 5 (2-9) d. The median (IQR) days to complete healing of the stoma site were 16 (10-18) d. The days to closure and days to complete healing were positively correlated. Factors positively correlated with increased days to closure included stoma size, increasing age, diabetes, and steroid use. Conclusions: These findings provide evidence that clinicians may consider when advising patients on what to expect after decannulation.