The treatment for non-healing wounds and coarse breath sounds after tracheotomy includes general therapy, anti-infective therapy, and rehabilitation management.
Wound healing after tracheotomy can be slow due to continuous mucus secretion from the airway and malnutrition.
The obstruction of the airway caused by the abundant and viscous endotracheal secretions or sputum plugs formed by dry crusts can cause coarse breathing. In addition, the lower airway is directly connected to the outside world after tracheotomy, which can lead to tracheal and lung infections.
For those who have the above situations, the treatment includes
1. General treatment: tracheotomy patients should strengthen nutrition to avoid non-healing of the incision due to malnutrition.
2. Anti-infection treatment: meropenem, cefoperazone sodium sulbactam sodium, moxifloxacin and so on.
3. Rehabilitation management: follow the doctor’s instructions to do sputum management (sputum attraction, etc.), as well as daily maintenance of lateral lying/supine double lower limb flexion position, early activities, etc.
4. Incision care: clinically, use 0.5% vital iodine to sterilize the skin of the incision every day, and pad sterile gauze at the incision. Oxygen therapy can also be used, i.e., after cleaning the incision with saline twice a day, 45% oxygen is used at a distance of 1cm from the incision, aligned with the diameter of the incision for 20min, which also achieves good results in preventing and treating incisional infections.
When the above treatments are ineffective, reopening the tracheotomy after cleaning the tracheotomy granulation tissue can be considered. Tracheotomy wound did not heal, breathing coarse recommended timely medical treatment by a specialist, do not blindly self-medication.