6. Tracheocutaneous fistula
Long-term tracheostomies often lead to epithelialization of the stoma
with mucocutaneous overgrowth in the artificial lumen at the stoma site
and tracheocutaneous fistulas 11. There is the direct
relationship between tracheostomy dependence times and the probability
of developing a tracheocutaneous fistula. This situation can be
explained by the need for more time for mucocutaneous overgrowth and
squamous epithelialization. In studies, the conclusion that this
critical time point is 24 months has come to the fore. The percentage of
children who develop tracheocutaneous fistula ranges from 13% to 57.3%
in the literature. Despite the longstanding and widespread use of
tracheostomies in medical practice, a standardized approach for
decannulation still does not yet exist among different practitioners.
Clinicians should develop a standard decannulation protocol to
decannulate patients as soon as appropriate to reduce the risk of
developing tracheocutaneous fistula 12.