ally drain into the innominate vein, the thymus can be easily separated from the pericardium and rotated upward to serve as a vascularized pedicle flap. The flap can separate the tracheostomy from the jeopardized substernal space. Thoracic transposition of the omentum flap could also be used to treat DSWI [5], but this would entail the additional trauma of a laparotomy. Our technique is relatively simple, and did not cause additional morbidity. The limitation of this technique may be its use in patients with a very atrophic thymus, in whom other techniques should be considered. In summary, we describe a case where a thymus pedicle flap could be used to eliminate contamination of airway bacteria in a patient with DSWI related to the tracheostomy. References