Background: Tracheal intubation is one of the most common emergency procedures performed for patients in intensive
care units. Many life-threatening complications result from improper nursing management regarding endotracheal tube
fixation. Various techniques have been utilized by critical care nurses to ensure endotracheal stabilization in order to
maintain a patent airway and prevent or minimize complications. The optimal stabilization method should not only be
secured but also requires other considerations as ease of use, few complications, and time effectiveness with patient
comfort. Thus, this study aimed to compare the effectiveness of Twill and adhesive tape techniques in securing the
endotracheal tube and maintaining the integrity of the oral mucous membrane among critically ill patients. Method: A
quasi-experimental research design was utilized to conduct this study among 74 orally intubated patients in three surgical
intensive care units affiliated with Mansoura Emergency Hospital in Egypt. Two tools were used to collect data for this
study; endotracheal tube placement assessment sheet and oral assessment guide scale. Results: There were highly
statistically significant differences between the two groups regarding the ETT slippage at 30, 60, and 120 minutes (P
=0.011 <0.001& < 0.001). Moreover, 5.4% of the participants in the Twill group had severe oral mucositis compared
with 27% of the participants in the adhesive tape group with statistically significant differences between the two groups
(P < 0.001). Conclusion: The Twill technique is more effective than the adhesive tape technique for securing the ETT
and maintaining the integrity of the oral mucous membrane among critically ill patients. Therefore, the Twill technique
is recommended to be used in intensive care units to ensure effective management during ETT routine care and avoid the
occurrence of slippage.