Are you a healthcare provider?
Additional Resources Contact Us

Read before changing ties!

Caution: If you use a cuffed tube, protect the inflation line when cutting the ties.
Change the location of the knot to prevent skin irritation.

It’s important to keep the area around the opening in the neck clean to help prevent infection. So, change ties daily or whenever they become wet or soiled.

Trach tube tie checklist

Blunt-nose scissors


Twill tape or tracheostomy tube holder

How to change twill tape ties


Wash your hands. (An assistant, if present, must wash hands, too.)


Leave the old ties in place. Pull one end of the twill tie through either neck flange hole. Adjust the ends of the tie until one is 3 to 4 inches longer than the other.


Bring both ends of the tie around your neck and insert the longer end of the tie through the other neck flange hole.


Pull the tie snug. Place one finger between the tie and the neck and tie the two ends together using a square knot. Do not use a bow.


Cut the ends of the ties leaving only 1 or 2 inches.


Carefully cut and remove soiled ties.

Get more details on skin care

The information and guidance presented on this website is informational only and not intended to influence practice or supersede the instructions for use of any specific device.

We gratefully acknowledge the contribution of the following individuals to the production of this content: Marie Lemoine, M.S.N., RN, RCP, Rob St. John, M.S.N., RN, RRT, Paula Thompson, B.S., RRT, and Missy Toigo, M.A., CCC-SLP