Foam Versus Silver‐Impregnated Foam Dressings for Pediatric Tracheostomy: A Randomized Trial

ABSTRACT Objective(s) Peristomal skin complications occur in up to 29% of pediatric tracheostomy patients. While foam dressings have demonstrated superiority over traditional gauze, comparative evidence regarding silver‐impregnated versus standard foam dressings remains limited. This study aimed to compare the effectiveness of standard foam versus silver‐impregnated foam dressing in preventing peristomal complications following pediatric tracheostomy. Methods This prospective randomized controlled trial enrolled 50 pediatric patients (aged 0–18 years) undergoing elective tracheostomy between March 2022 and July 2024. Patients were randomly assigned to receive either standard foam dressing (Group A, n = 25) or silver‐impregnated foam dressing (Group B, n = 25). All patients followed a standardized postoperative care protocol. The primary outcome was incidence of peristomal complications during the first postoperative month. Secondary outcomes included pressure ulcer risk assessment using the Braden Q Scale and wound staging according to the National Pressure Injury Advisory Panel (NPIAP) classification. Results The complication rate was 12% ( n = 3) in the foam dressing group and 8% ( n = 2) in the silver‐impregnated foam dressing group, and no statistically significant difference was detected (risk difference: 4%, 95% CI: −0.114 to 0.194, p = 1.000). No significant differences were observed in Braden Q scores on postoperative days 1, 7, 14, and 21 ( p > 0.05). NPIAP staging revealed comparable pressure ulcer severity between groups ( p = 1.000). Conclusion No statistically significant difference was detected between standard foam and silver‐impregnated foam dressing when combined with standardized care protocols. However, the small sample size limits statistical power to detect clinically meaningful differences, and as this study was not designed as a non‐inferiority trial, equivalence cannot be concluded. Larger trials are needed to confirm these findings. Standard foam dressing may be a lower‐cost option for routine postoperative wound management in pediatric tracheostomy patients. Level of Evidence 2. Trial Registration: NCT07392294.