Management of tracheocutaneous fistula

We describe a simple technique that utilises local skin flaps of closure of a large tracheocutaneous-fistula with a adequate support to the tracheal wall by double breasting of local flaps, thus avoiding the post-operative respiratory problems that can occur due to a single flap projecting into the tracheal lumen during inspiration.This technique avoids the complications associated with primary closure of fistulae & also the morbidity of waiting for secondary closure to occur. It also precludes the need for a more extensive operation in the form of muscle flap rotation. The fistulous tract does not need to be excised but forms a component of the repair.