(2) With a knife and #15 blade, a vertical incision is made in the trachea
directly across the two tracheal rings. The cut ends of the cricoid cartilage are retracted
with a hook.
(3) The previously prepared tracheostomy tube (see figure 1-12) is inserted
into the trachea, the obturator is quickly removed, and the trachea is suctioned with a
(4) The wound edges are lightly approximated with silk sutures or the
wound edges are allowed to fall together around the tube. One or two skin sutures are
inserted above the tube. The lower angle of the wound may be left open for drainage.
Figure 1-12. Metal tracheostomy tube. A-Parts of a metaltracheostomy tube.
B-Tracheostomy ties and gauze pants in place.
(5) The tracheostomy tube is held in place with tapes tied with a square knot
behind the neck. The inner tube is then inserted. A gauze dressing split around the
tube is applied to the wound. Assembler
1-39. EXCISION OF THE SUBMAXILLARY GLAND
a. General. This operation involves the removal of the gland and tumor through
an incision made in the neck, just beneath the chin. It is performed to remove mixed
tumors and multiple calculi associated with extensive chronic inflammation.
b. Preparation of the Patient. The patient is placed on the table in a dorsal
recumbent position, with the affected side uppermost, and prepared as for neck surgery.