A Simple Method for Closure of Tracheocutaneous Fistula in Children

Comparison of 2 Techniques of Tracheocutaneous Fistula Closure

“…Various procedures to close a TCF include excision of the TCF alone, partial excision of the TCF with closure, and full excision of the TCF with closure. [9][10][11][12][13] Ultimately, each technique has been successful at achieving closure of the fistulous tract and has been associated with a low rate of complications. Transcutaneous fistula excision has the advantage of increased safety.…”

“…The optimal technique used to treat TCF has been debated in the literature and varies among different pediatric hospitals. 1,[8][9][10][11][12] This study represents a comparative analysis of 2 different interventions for persistent TCF performed at the same institution. Our experimental hypothesis was that TCF excision alone and healing by secondary intent would have equivalent success rates and decreased complication rates compared with formal TCF closure.…”

Closure of persistent tracheocutaneous fistula following “starplasty” tracheostomy in children

“…A variety of TCF closure techniques have been advocated and can be classified as primary closure in layers [13], primary closure with fistulectomy [2,7,14,16] and fistulectomy with closure by secondary intent [8,10,12,15]. Some authors argue that primary closure is associated with an unacceptable complication rate, opting instead for closure by secondary intention [3,8,10,12].…”

“…Some authors argue that primary closure is associated with an unacceptable complication rate, opting instead for closure by secondary intention [3,8,10,12]. Other authors cite low complication rates, improved cosmetic results and the ability to observe the patient in the hospital following immediate closure [2,7,13,14,16]. Our choice of closure technique, fistulectomy and primary closure in layers, has been guided by the specific anatomical design of the ''starplasty'' itself as well as by our uncomplicated experience with primary layered TCF closure following decannulation of children with standard tracheotomies.…”

Tracheocutaneous Fistula Closure in the Pediatric Population: Should Secondary Closure Be the Standard of Care?

“…10 Many variations of primary closure have been developed and claim to reduce risks while maintaining cosmetic benefit and convenience; however, large and long-term studies of such methods are absent. [11][12][13][14][15][16] We have previously compared the 2 methods of TCF closure at our institution and found no significant differences in risks or efficacy between primary closure and secondary intention. 9 Shortly after this study was published, we experienced 2 serious complications using the primary closure method.…”