2021 Volume 67 Issue 3 Pages 183-192
We herein report tracheostomy performed due to leg cellulitis in a patient with severe obesity. A 39-years-old man with a body mass index exceeding 66.1 developed a fever, reddening and swelling of his right leg. He was diagnosed with right leg cellulitis and emergently admitted to the hospital. He needed a ventilator due to respiratory failure induced by sepsis. Despite resolving the cellulitis by antibiotics, the patient developed hypercapnia and was difficult to extubate. Due to long-term ventilation, we performed tracheostomy under general anesthesia. We made a convex incision 10 cm long and a subplatysmal flap and then removed subcutaneous adipose tissue from the superior subplatysmal flap to decrease the distance from the skin to the trachea. After dissecting the trachea under the cricoid cartilage, we inserted an adjustable-length and flexible tracheostomy tube, into the trachea. He was able to be weaned from the ventilator, and successful decannulation occurred on postoperative day 84. He was discharged without severe complications.
