Management of tracheocutaneous fistula

In our experience, recommended treatment of the closure of tracheocutaneous fistula has been disappointing. Complications associated with primary closure, which we have experienced, include pneumomediastinum, pneumothorax, and wound breakdown. The alternate method of treating tracheocutaneous fistula, which we recommend, consists of excision of the tract down to the level of the trachea and allowing healing to take place via secondary intention. Elective scar revision, if indicated, is scheduled at some time in the future.