Tracheostomy Care: Changing Velcro Trach Ties

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Trach ties are the bands that go around the neck. They hold the trach tube in place. Trach ties are made of different materials. Most often, a soft cloth with Velcro® is used. The trach tie may be one continuous piece of material. It may also be in two parts with another Velcro fastener..

Change the ties whenever they are wet or dirty. Otherwise, trach ties are changed every 24 hours. It is important to keep the ties clean and dry. Wet or dirty trach ties can irritate the skin. When the skin gets red and sore, it can become infected. If your child has any skin problems, call the doctor.

You may need another person to help you change the trach ties. One of you holds the trach in place when the ties are removed. The other removes the used trach tie, cleans the skin, replaces a clean trach tie, and tightens it to keep the trach tube in the stoma.


  • Suction machine and suction supplies
  • Sterile tracheostomy tube
  • Soap and water
  • Two clean washcloths
  • Clean trach tie
  • Scissors with rounded ends

How to Change the Velcro Trach Ties

  1. Wash your hands well. The person helping you should also wash his or her hands. Rinse and dry.
  2. Remove trach ties from package.
  3. Cut the longer Velcro strap to the right length if it is a 2-piece tie.
  4. Suction the trach if needed.
  5. Another person holds the trach in place.
  6. Remove the old tie on one side by loosening the Velcro.
  7. Gently wash the skin on that side with soap and water.Check the skin for redness, breaks, or odor. Pat dry.
  8. With the Velcro facing up, slip one side of the tie through the flange on the trach.
  9. Repeat steps 5 through 7 on the other side of the neck.
  10. Secure the ties in the back by overlapping the Velcro. Tighten to allow only one finger between the trach tie and the child’s neck.

Other Information

  • Do not change trach ties right after your child has eaten. Wait at least two hours.
  • If you notice any signs of redness, breaks in the skin, or unusual odor, call your child’s doctor for advice.
  • You may need to change the ties more often if your child’s neck gets red and irritated.
  • Check to see that the trach is in the middle of the neck, lined up with the belly button and the nose.
  • Be sure the ties are secured tightly enough to keep the trach tube in the proper place.
  • It is usually easier to change trach tube ties if your child is lying on his back on a flat surface with his neck extended.
  • Always keep the extra trach tube handy when you are changing ties, just in case the one in your child’s trachea comes out accidentally.
  • Do NOT use the Velcro ties for any child who might try to undo them himself (such as a toddler).

Tracheostomy Care: Changing Velcro Trach Ties (PDF)

HH-II-201 5/12, Reviewed 4/15 Copyright 2012, Nationwide Children’s Hospital