Construction and Design of Tracheostomy Tubes
Most modern tracheostomy tubes are made of medical-grade plastics such as silicone, polyvinyl chloride, polyurethane, or a combination. Early tracheostomy tubes were metal, either stainless steel or silver. Some people still use these, but most prefer the lighter plastic materials since they are also cheaper and easier to modify if necessary, and depending on the material, more pliable. Also metal tubes do not have a cuff so can't be connected to a ventilator. Metal tubes or tubes made of polyurethane are thin-walled and thus have a larger lumen. PVC tubes have a thicker wall that limit the size of the lumen, but are very lightweight and more comfortable for long-term users.
These main components of a tracheostomy tube are universal: The tube shaft is arc-shaped and with either a single cannula or dual cannula. It may have a cuff to provide an airtight seal facilitating positive pressure ventilation and reducing the risk of aspiration. The neck flange helps secure and stabilize the tracheostomy tube to the neck by using neck straps. For ease of insertion it is supplied with an obturator.
Short term tracheostomy tubes have a 15mm connector to allow attachment to airway equipment. Long term tracheostomy tubes may have a low profile flange which is more discreet but cannot be attached to airway equipment.
Extralong Tubes: Sometimes an extralong tube is needed in cases of unusual anatomy, unusual pathology or obesity. We will customize the length to be suitable for individual patients.
Short/Laryngectomy: For users who, after laryngectomy, have had a voice prosthesis surgically inserted into a fistula between the esophagus and trachea. The tube is necessary in order to keep the stoma open.
Pediatric/Neonatal: The unique attributes of infants and children require special tubes that come in a range of sizes. Due to their small size, the tracheostomy tubes are single lumen and cuffs are avoided due to the delicate nature of the still developing trachea tissue. To avoid build-up of secretions, the tubes have to be changed more frequently.
Adjustable flange tubes: Some tubes have adjustable flanges which can be adjusted to accommodate unusual neck anatomy.