Closure of Paediatric Tracheocutaneous Fistula: Surgical Technique

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dc.contributor.authorHlomani, Buhlebenkosi
dc.contributor.authorPeer, Shazia
dc.contributor.editorFagan, Johan
dc.date.accessioned2026-07-07T09:48:12Z
dc.date.available2026-07-07T09:48:12Z
dc.date.issued2025-03-03
dc.description.abstractA tracheocutaneous fistula (TCF) is an epithelial-lined communication between skin and trachea that persists after decannulation (removal) of a tracheostomy tube. TCF rates are higher in paediatric patients. It is a recognised complication of long-standing tracheostomies and has been linked to long-er duration of tracheostomy dependence. Complications associated with a persistent TCF include skin irritation; inadequate glottic closure causing a weak cough and air-way compromise; poor phonation; poor cosmesis; increased risk of aspiration during swimming, bathing etc. Addressing a persistent TCF avoids delays with integration into society and mainstream schooling. TCF is due to squamous epithelialisation of the tracheostomy tract. Closure is achieved by excising the fistula followed either by primary closure or allowing for healing to occur by secondary intention. Although primary closure provides immediate resolution of the fistula and better cosmesis, it may be associated with life-threatening complications. Allowing healing by secondary intention minimises such potential complications. It may however be perceived as “inconvenient” for the patients.
dc.identifier.apacitationHlomani, B., & Peer, S. (2025). Closure of Paediatric Tracheocutaneous Fistula: Surgical Technique. In J. Fagan. (Ed.), <i>Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery</i> (pp.7). Cape Town, South Africa: University of Cape Town. http://hdl.handle.net/11427/43493en_ZA
dc.identifier.chicagocitationHlomani, Buhlebenkosi, and Shazia Peer. "Closure of Paediatric Tracheocutaneous Fistula: Surgical Technique" In <i>OPEN ACCESS ATLAS OF OTOLARYNGOLOGY, HEAD & NECK OPERATIVE SURGERY</i>, edited by Johan Fagan., 7. Cape Town, South Africa: University of Cape Town. 2025. http://hdl.handle.net/11427/43493.en_ZA
dc.identifier.citationHlomani, B. & Peer, S. 2025. Closure of Paediatric Tracheocutaneous Fistula: Surgical Technique. In <i>Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery</i>. J. Fagan, Ed.Cape Town, South Africa: University of Cape Town. 7. http://hdl.handle.net/11427/43493 .en_ZA
dc.identifier.ris TY - Chapter in Book AU - Hlomani, Buhlebenkosi AU - Peer, Shazia AB - A tracheocutaneous fistula (TCF) is an epithelial-lined communication between skin and trachea that persists after decannulation (removal) of a tracheostomy tube. TCF rates are higher in paediatric patients. It is a recognised complication of long-standing tracheostomies and has been linked to long-er duration of tracheostomy dependence. Complications associated with a persistent TCF include skin irritation; inadequate glottic closure causing a weak cough and air-way compromise; poor phonation; poor cosmesis; increased risk of aspiration during swimming, bathing etc. Addressing a persistent TCF avoids delays with integration into society and mainstream schooling. TCF is due to squamous epithelialisation of the tracheostomy tract. Closure is achieved by excising the fistula followed either by primary closure or allowing for healing to occur by secondary intention. Although primary closure provides immediate resolution of the fistula and better cosmesis, it may be associated with life-threatening complications. Allowing healing by secondary intention minimises such potential complications. It may however be perceived as “inconvenient” for the patients. CY - Cape Town, South Africa DA - 2025-03-03 DB - OpenUCT DP - University of Cape Town ED - Fagan, Johan J1 - Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery KW - Closure, Paediatric, TCP, Tracheocutaneous Fistula, Tracheostomy, Surgery, Technique LK - https://open.uct.ac.za PP - Cape Town, South Africa PY - 2025 T1 - Closure of Paediatric Tracheocutaneous Fistula: Surgical Technique TI - Closure of Paediatric Tracheocutaneous Fistula: Surgical Technique UR - http://hdl.handle.net/11427/43493 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/43493
dc.identifier.vancouvercitationHlomani B, Peer S. Closure of Paediatric Tracheocutaneous Fistula: Surgical Technique. In Fagan J, editor.. Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery. Cape Town, South Africa: University of Cape Town; 2025. p.7. [cited yyyy month dd]. http://hdl.handle.net/11427/43493.en_ZA
dc.language.isoen
dc.publisherUniversity of Cape Town
dc.publisher.departmentDivision of Otorhinolaryngology
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.locationCape Town, South Africa
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.sourceOpen Access Atlas of Otolaryngology, Head & Neck Operative Surgery
dc.source.pagination7
dc.subjectClosure, Paediatric, TCP, Tracheocutaneous Fistula, Tracheostomy, Surgery, Technique
dc.titleClosure of Paediatric Tracheocutaneous Fistula: Surgical Technique
dc.typeChapter in Book
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