Comparison of Pediatric Tracheostomy Stoma Cleaning Solutions

BACKGROUND: In the limited literature on cleaning tracheostomy stoma sites, there is no standard guideline for the cleaning solution. The objective of this study was to determine whether signs of stoma-site infection were different among a hospitalized pediatric population when using sterile water, sterile saline solution, or 0.25% acetic acid solution for tracheostomy stoma cleaning. METHODS: A retrospective chart review was completed and included nursing and physician notes. The subjects were RESULTS: In the 102 subjects included, there were significantly more signs of infection in the subjects for whom 0.25% acetic acid was not used for daily stoma cleaning (P = .03). There were no differences in signs of infection between those cleaned with saline solution (39%) and those cleaned with sterile water (31%) for daily stoma cleaning. Overall, there were 29% fewer signs of infection when 0.25% acetic acid was used than either sterile water or saline solution. CONCLUSIONS: Analysis of our findings indicated that a 0.25% acetic acid solution used for stoma cleaning may be associated with fewer signs of infection than sterile water or sterile saline solution. More research is warranted toward establishing a standard practice.