Tracheocutaneous fistula closure by two hinged turnover flap and a fasciocutaneous pivot flap

Abstract

Tracheocutaneous fistula is a known complication in patient who are tracheostomised for long duration. A 18-year-old girl presented in our department who was tracheostomised 2 years back, to secure airway, following a road traffic accident and tracheal injury. She underwent multiple surgeries to maintain upper airway, which were successful, but developed a tracheocutaneous fistula due to prolonged tracheostomy. Surgical closure of the fistula was done using a two hinged turnover flap and a fasciocutaneous pivot flap. The patient was discharged on 6 day of the surgery with no complication and no recurrence. Our technique explains one of the many procedures used to close a tracheocutaneous fistula, mentioned in literature. It is minimally invasive and is associated with minimal chance of tracheal stenosis and recurrence.