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A tracheostomy is a hole in a person’s neck that is created by a tracheotomy. This surgical procedure is performed when a person is unable to breathe normally, and instead breathes through the tracheostomy because the upper part of his or her airway is blocked. Once the hole is made, it must be kept open artificially, usually with a piece of equipment known as a tracheostomy tube, often shortened to simply "trach tube". This tube is help in place by ties made of fabric or other material that wrap around the person’s neck and are tied securely to hold the tube in place.
The trach tube typically has four openings in front, either one or two on each side of the neck plate surrounding the central opening, to allow the device to be held firmly in place. A tracheostomy tie is placed in each hole and fastened there securely, usually with a square knot or other knot that cannot easily come undone. The ties are brought to the back of the person’s neck and tied in place tightly enough to hold the tube steady, but left loose enough that a finger can still be slipped under each tie.
It is quite common for a tracheostomy tie to be made of twill tape, cotton shoelace, or other type of soft fabric. The problem with such materials is that they can trap moisture, resulting in skin irritation, rashes, and other related issues. Changing the tracheostomy tie on a daily basis can help to minimize this type of skin problem, as can using ties made of other materials that don’t trap as much moisture.
A tracheostomy tie may be made of a soft, wide strap that is fastened with Velcro®. This type of tracheostomy tie is not necessarily appropriate for children, as they may be able to loosen it or to remove it completely, but for older patients it can greatly simplify the process of changing ties. In many cases a Velcro® tracheostomy tie may be reusable, but usually not more than once or twice since such ties are often made disposable material.
In addition to more traditional ties, another method for holding a trach tube in place is a tracheostomy collar. This is similar to a tracheostomy tie and serves the same purpose, but is wider and tends to fit more like a collar than a piece of string around the neck. Typically, these are washable and reusable, though they are not meant for long-term use, and come in different sizes in order to provide the most comfortable fit. These collars are intended to minimize neck irritation, making life as comfortable as possible for the person who has a tracheostomy.
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