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Trach stoma not closing
My brother had a neck surgery last year, requiring a tracheotomy for over ten months.  The trach tube was removed, and he was told due that, due to his age and diabetes and how long he had the trach, it might take a month or more for the stoma to heal over. Four months later, it shows no signs of closing. It is like the earring hole in your ears, basically permanent, as far as I can see. What can be done? Can it be debrided or facilitated surgically somehow?
The next problem is that, if he was weaned before they removed the trach, the weaning has reversed. He breathes only through the trach stoma, and for the past 4 months, that is room air filtered only by the gauze dressing.
Would you recommend starting over? Replacing the trach so it can be capped for training mouth/nose breathing or using a Passy Muir or another standard weaning protocol?  I am afraid the stoma has no chance of healing over if it is his primary airway.
Thanks for your advice.
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1129962_tn?1261288629
I am a trached person..I have known others who had trachs removed but had problems with their stoma closing. There is surgery that can close the hole, it sounds like your brother would benefit from this. See an ENT about this as they have the expertise dealing with trachs. As far as breathing through his stoma, it makes sense that he is...I can tell you from personal experience that if I walked around with my trach uncapped and open, that breathing would be primarily through the tube as it is lower than my mouth and nose. When I cover it up, I am able to breathe through my nose and mouth as long as my cuff is deflated as well. Is your brother able to do this....have him cover up his stoma with a clean hand and see if he can breathe through his mouth/nose. If he can, he will probably be fine.
Remember, I am not a doctor...the doc will be able to give the best advice. I hope his stoma heals soon. Must be frustrating for him.
Jenn
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I was in Intensive care for about 2 months  in 2011. I had a trachostomy done to help with my breathing. Well I had that one taken out and went through rehab and was ready to go home . when they came to my room to pull off my feeding tube they had  ruptured something  in my stomach ,so I had to go for emergency surgery . In surgery they put another trachtube in in to help me breath. now I am waiting and they sent me to a nursing home rehab .before I left they put what they called a jackson tube in.. but to make it short I was in nursing home for about 7 months and they changed it a couple times, It has been well over a year that they were able to take the trach out and the stoma is still open . I keep it shut with a bandage ove it it is nto a big hole but enough that air escapes. It upsets me becasue I used to sing and now I have trouble getting the sounds to come out properly


Ed  
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make a poultice with slippery elm. It heals wounds very well.
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