Reconstruction of Tracheocutaneous Fistula by Pedicled Flaps

Tracheocutaneous fistulas present secondary to homicide, suicide, and accidents. Most of the times, they can be repaired primarily, with secondary reconstruction required in complex cases. Such reconstructions can be performed using pedicled flaps without much difficulty. Any surgeon, without the need of microsurgical expertise or special instrumentation, can perform such reconstruction. Three patients presented to the department following homicidal cutthroat injuries, with trachea-cutaneous fistula. Two patients were managed with pectoralis major musculocutaneous flaps and one was managed with sternocleidomastoid flap. All patients attained good wound healing and fistula closure. The two skin paddles provided lining and cover, and the intervening muscle provided an additional waterproofing. These flaps are a reliable method of reconstructing such defects.