Objective:

To systematically evaluate the efficacy of interventions for preventing pressure injuries in tracheostomized children and to compare the impact of different preventive measures on pressure injury incidence and severity, providing an evidence base for clinical nursing practice.

Key Findings:

• Six studies with 736 participants were included.
• Velcro® ties showed a significant reduction in adverse event risk compared to conventional twill ties (OR = 0.26).
• Mepilex® Ag demonstrated a higher probability of being the optimal intervention (SUCRA = 97.6%) compared to standard care and Mepilex®, although none achieved statistical significance.

Interpretation:

The findings suggest potential value in using silver-containing foam dressings and Velcro®-type securement devices for preventing tracheostomy-related pressure injuries in pediatric patients, but the lack of statistical significance indicates caution in interpretation.

Limitations:

• Moderate certainty of evidence due to the limited number of studies, which may affect the reliability of the findings.
• Variable methodological quality among included studies could introduce bias.
• Substantial heterogeneity in study designs and outcomes limits the generalizability of the results.

Conclusion:

High-quality randomized controlled trials and real-world studies are urgently needed to establish standardized clinical practice guidelines for preventing tracheostomy-related pressure injuries in children, ultimately improving outcomes for this vulnerable population.