A simple technique for tracheocutaneous fistula surgical closure

  • Armando De Virgilio
  • Antonio Greco
  • Maria Ida Rizzo
  • Andrea Gallo
  • Giulio Pagliuca
  • Salvatore Martellucci
  • Marco de Vincentiis
Keywords: Tracheocutaneous fistula;, tracheostomy;, decannulation;, tracheal cannula;

Abstract

Tracheocutaneous fistula (TCF) is commonly regarded as a pathologic complication of temporary tracheostomy, resulting from failure of the spontaneous tracheostomy closure after decannulation. The aim of the present study is to describe and to report the results of a our simple TCF closure surgical technique. Ten patients with TCF were prospectively enrolled at the Sensory Organs Department of Policlinico “Umberto I”, “Sapienza” University of Rome between February 2011 and May 2013. The surgical procedure, performed under local anesthesia, is decribed in detail.
TCF surgical closure was accomplished successfully in all cases. All patients experienced regular postoperative courses during the first week without complications in terms of bleeding or airway compromise. Only 1 (10%) patient required a surgical revision consisting of debriding of the margins and closure with simple sutures.
The reported technique was shown to be safe, simple and feasible. However particular caution should be required in patients with chronic aspiration and cough which may cause wound dehiscence and fistula recurrence in the early post-operative period.

Published
2018-03-05