This review and meta-analysis looked at ways to prevent pressure injuries in children with tracheostomies. It compared Velcro ties to conventional twill ties, and Mepilex and Mepilex Ag dressings to standard care. The analysis included 736 pediatric participants.
The main finding was that Velcro ties were linked to a lower risk of adverse events compared to conventional ties. For the dressings, the results were not statistically significant, meaning the differences could be due to chance. A ranking analysis suggested Mepilex Ag had the highest probability of being optimal, but this is only indicative.
The study had several limitations. There were few available studies, the methods varied, and the results had wide intervals, showing substantial uncertainty. No safety concerns were reported, but the evidence is not strong enough to change practice.
The main reason to be careful is that none of the direct comparisons were statistically significant. Readers should see this as preliminary evidence that certain devices and dressings might help, but more research is needed.