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LETTER TO EDITOR Table of Contents   
Year : 2008  |  Volume : 11  |  Issue : 2  |  Page : 131
Percutaneous tracheostomy: A comparison of PercuTwist and multi-dilatators techniques

Department of Anaesthesiology and Reanimation, Mersin University Medical Faculty, Mersin, Turkey

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How to cite this article:
Birbicer H, Doruk N, Yapici D, Atici S, Altunkan AA, Epozdemir S, Oral U. Percutaneous tracheostomy: A comparison of PercuTwist and multi-dilatators techniques. Ann Card Anaesth 2008;11:131

How to cite this URL:
Birbicer H, Doruk N, Yapici D, Atici S, Altunkan AA, Epozdemir S, Oral U. Percutaneous tracheostomy: A comparison of PercuTwist and multi-dilatators techniques. Ann Card Anaesth [serial online] 2008 [cited 2022 Jun 29];11:131. Available from:

The Editor,

Tracheostomy is one of the invasive procedures frequently performed in order to continue the air passage in intensive care patients who need mechanical ventilation for a protracted period of time. The latest method is the single-step (PercuTwist) technique applied with the use of a screw-like dilator. [1],[2] The purpose of this letter is to present the early complication rate and safety of multi-dilatational percutaneous tracheostomy (Ciaglia) with the single-step rotating dilatation tracheostomy procedure.

Records of 100 patients were evaluated, who randomly underwent either multi-dilatational percutaneous tracheostomy (Group C, n = 50) or single-step rotating dilation tracheostomy (Group PT, n = 50), under the guide of fibreoptic bronchoscope (Karl Storz 11001 RD). Preoperative and postoperative complications were examined. Seventy hours after the tracheostomy procedure, wound culture samples were taken for stomal infection. All procedures were carried out by intensive care specialists (anaesthesiologist) in the ICU. Statistical analyses were performed using the Chi-squared test and Student's t -test.

No significant difference was detected between the groups in terms of the patients' demographics [Table 1]. Duration of the procedure was determined as 2.9 ± 0.7 minute in Group PT and 4.1 ± 0.5 minute in Group C ( P < 0.05). The rate of complications between the groups was not statistically significant [Table 2]. Wound cultures were positive in 27% of patients in Group PT and 18% in Group C. There was no statistically significant difference in the wound cultures of the two groups ( P = 0.33). Stomal infection was not observed in both the study groups.

Percutaneous tracheostomy techniques are commonly used procedures in intensive care units. It can be concluded that percutaneous techniques were found safe in tracheostomy procedure. Yet, differences have been observed among percutaneous techniques in terms of complication rates, and it has been found that more serious and major complications arise in sequential techniques as compared to single-step techniques. [3],[4] Although single-step rotating dilatation tracheostomy is a newer procedure, we believe that PercuTwist method is a promising one in that it is easy and simple to implement, and it causes fewer early complications when compared with Ciaglia technique.

   References Top

1.Frova G, Quintel M. A new simple method for percutaneous tracheostomy: Controlled rotating dilation. Int Care Med 2002;28:299-302  Back to cited text no. 1    
2.Westphal K, Maeser D, Scheifler G, Lischke V, Byhahn C. PercuTwist: A new single-dilator technigue for percutaneous tracheostomy. Anesth Analg 2003;96:229-32.  Back to cited text no. 2    
3.Trottier SJ, Hazard PB, Sakabu SA, Levine JH, Trop BR, Thompson JA, et al . Posterior tracheal wall perforation during percutaneous dilational tracheostomy: An investigation into its mechanism and prevention. Chest 1999;115:1383-9.  Back to cited text no. 3    
4.Marx WH, Ciaglia P, Graniero KD. Some important details in the technigue of percutaneous dilational tracheostomy via the modified Seldinger technigue. Chest 1996;110:762-6.  Back to cited text no. 4  [PUBMED]  [FULLTEXT]

Correspondence Address:
Handan Birbicer
Mersin University, Faculty of Medicine, Department of Anaesthesiology and Reanimation, 33079, Mersin
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0971-9784.41585

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  [Table 1], [Table 2]

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