ReviewFrontiers in pediatrics2026
Quality improvement strategies for preventing tracheostomy-related pressure injuries in children: a systematic review and meta-analysis.
Review in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Children with tracheostomies represent a high-risk population for medical device-related pressure injuries (MDRPI) due to prolonged cannulation, immature skin, limited mobility, and exposure to secretions, consistent with NPIAP/EPUAP definitions. The development of pressure injuries not only prolongs hospitalization and escalates healthcare costs but may also precipitate severe infectious complications. Although diverse preventive strategies have been implemented in clinical settings, evidence-based synthesis specifically targeting the pediatric population remains scarce, and the comparative effectiveness of these interventions continues to be debated. Objective: To systematically evaluate the efficacy of interventions for preventing pressure injuries in tracheostomized children and to compare, through meta-analysis, the impact of different preventive measures (including securement methods and dressing types) on pressure injury incidence and severity, thereby furnishing an evidence base for clinical nursing practice. Methods: A comprehensive computerized search of Chinese and international databases was conducted to identify clinical studies examining preventive interventions for pressure injuries in children (aged ≤18 years) with tracheostomies. Meta-analyses of pressure injury incidence were performed using R software and STATA. Results: A total of 6 studies encompassing 736 participants were included. Direct Bayesian meta-analysis of three studies comparing Velcro® ties with conventional twill ties showed a reduction in adverse event risk favoring the Velcro® group (OR = 0.26, 95% CrI 0.07-0.94), with a continuity correction of 0.5 applied for zero events. Bayesian network meta-analysis comparing Mepilex®, Mepilex® Ag, and standard care revealed that, relative to control, the OR for Mepilex® was 0.83 (95% CrI: 0.02-21.48) and for Mepilex® Ag was 0.32 (95% CrI: 0.003-11.37). Node-splitting analyses indicated no significant inconsistency between direct and indirect evidence (all Conclusion: This systematic review and meta-analysis provides preliminary evidence supporting the potential value of silver-containing foam dressings and Velcro®-type securement devices in preventing tracheostomy-related pressure injuries among pediatric patients. However, the certainty of evidence remains moderate, constrained by the limited number of available studies, variable methodological quality, and substantial heterogeneity. Clinical decision-makers should integrate individual patient characteristics, resource availability, and cost-effectiveness considerations when selecting appropriate preventive regimens. High-quality randomized controlled trials and real-world studies are urgently warranted to establish standardized clinical practice guidelines for preventing tracheostomy-related pressure injuries in children, ultimately improving outcomes for this vulnerable population. Systematic Review Registration: INPLASY202650137 (INPLASY.COM, DOI: 10.37766/inplasy2026.5.0137).
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.