A tracheostomy collar is a medical device used by individuals who have undergone a tracheostomy, a surgical procedure that creates an opening, or stoma, in the windpipe. The collar is designed to fit around the neck and cover the stoma where a tracheostomy tube has been inserted. This apparatus sits directly over the stoma, providing a controlled environment for the air entering the airway and protecting the area.
Primary Function of the Collar
The primary purpose of the tracheostomy collar is to deliver supplemental oxygen or controlled air directly to the tracheostomy opening. When the natural upper airway—the nose and mouth—is bypassed by a tracheostomy tube, the air entering the lungs is no longer warmed, filtered, or moisturized. This loss of natural air conditioning makes the air dry and cool, which can cause irritation to the sensitive lining of the trachea and lungs.
The collar is most often connected to a humidification system, such as a heated nebulizer, to add water vapor to the inhaled air. Humidification prevents the thickening and drying of respiratory secretions, which could lead to mucus plugs that obstruct the tube. By keeping the mucus thin and loose, the collar aids in maintaining clear airways and reducing the risk of complications.
The device can also deliver prescribed concentrations of oxygen, which is mixed with the humidified air before reaching the stoma. Continuous delivery of moisturized air is necessary for patients who have recently had a tracheostomy or those who produce thick secretions. The collar ensures the inspired gas meets moisture content requirements, compensating for the bypassed functions of the nose and pharynx.
Structural Components and Design
A tracheostomy collar is typically composed of a wide, soft band of material that wraps around the patient’s neck. The band is often made from soft foam, neoprene, or cotton to prevent skin irritation. The design prioritizes a secure but non-constricting fit, achieved through an adjustable neck strap or fastener.
The collar is secured using fasteners like Velcro or ties, which are inserted through the eyelets in the faceplate (flange) of the tracheostomy tube. This connection ensures the tracheostomy tube remains anchored, preventing accidental dislodgement. The central feature of the collar is a specialized port or connector where the tubing from the oxygen or humidification source attaches.
This port directs the conditioned air flow into the immediate vicinity of the stoma opening. The material choice and adjustable nature of the collar accommodate different neck sizes and reduce pressure against the skin of the neck.
Practical Application and Maintenance
Proper placement of the tracheostomy collar is achieved when it is secure enough to prevent the tube from moving but loose enough to allow for two fingers to fit comfortably underneath the band. This check ensures the collar is not causing excessive pressure, which could lead to skin breakdown or restrict blood flow. The collar should be adjusted to keep the tracheostomy tube properly positioned and prevent it from being pulled out.
Caregivers must routinely inspect the skin under and around the collar and stoma for any signs of irritation, redness, discharge, or odors, which may indicate infection or pressure injury. Daily cleaning of the stoma site with saline solution and monitoring the surrounding skin is a standard part of maintenance. The cleaning procedure often involves using a mild soap and water to gently clean the area beneath the collar.
The tracheostomy collar itself requires regular cleaning or replacement to maintain hygiene and prevent the buildup of secretions. Disposable collars are often replaced daily or whenever they become soiled or wet. Reusable collars, such as certain foam devices, should be hand-washed with mild detergent, thoroughly rinsed, and air-dried. It is also important to monitor the tubing connected to the humidification source for condensation, or “rain-out,” which is water that collects in the tube and must be regularly drained to prevent it from entering the airway.