Repair of persistent tracheocutaneous fistula using non-overlapping double-layer hinged skin flap: a preliminary...

Tracheocutaneous fistula (TCF) is a common complication following tracheostomy tube removal. Although persistent TCF is not life-threatening, it profoundly compromises the quality of life for patients, leading to functional, aesthetic and psychosocial challenges. Numerous surgical techniques for the closure of TCFs have been documented in the literature, however, these methods are often associated with varying degrees of postoperative complications and suboptimal success rates. To address these limitations and enhance the efficacy of the TCF repair, we developed an innovative approach utilizing the double-layer hinged skin flap, aiming to minimize complications and optimize closure success rates. This retrospective study, conducted between 2019 and 2024, included 18 patients who underwent surgical closure of TCFs using the proposed technique. The surgical technique involves the creation of non-overlapping double-layer hinged skin flaps around the TCF, which are then meticulously positioned to achieve complete closure of the tracheostomy site. All cases achieved successful closure of the TCFs with outstanding cosmetic outcomes. The procedure is both safe and straightforward, offering a feasible and advantageous novel approach for managing TCFs in clinical practice.