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.