Re: Surgical closure of trach stoma

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Surgical closure of trach stoma

> I have a question for anyone who has had to have a trach stoma

> surgically closed after decannulation. Aubrey (3.5 yrs old) was

> decannulated recently, but since she had the trach for so long, the

> stoma will not close on its own.

We had a very similar situation with our son . He was twelve and a

half when he was decannulated, had the trach since six weeks of age, and the

stoma did not close on its own either. I love the name for it - " persistent

fistula " . The skin closed quite a bit, leaving a hole the size of a pencil

lead tip - but we found out later that the tract between the skin and the

trachea was completely intact, and the hole in the trachea was not any

smaller.

> Our ENT informed us that to surgically

> close the stoma she will have to go under anesthesia and the ENT will

> stitch the inside part at the trachea closed, the muscle in-between and

> the outside.

Yes. went under anesthesia. The tract between the trachea and the

skin was excised. An area of skin that must have resembled in shape the

skin of an orange section was also removed. He came out of surgery with a

single horizontal line incision about two inches in length with a very fine

(but strong) stitch that weaved in and out of all the various layers.

had to go to the ENT's office to have the stitches removed two weeks

post-op. He was in the surgery room about forty minutes for the closure.

>She said that she will need to place a small drain tube

> that hangs out for a day or 2 to let air flow thru. Apparently,

> according to her, if you don't do that an oxygen bubble can get in there

> and travel to the lungs causing some kind of pneumonia. She said that

> this could still potentially happen, even with the tube - she has had it

> happen twice, but has done many of these. Has anyone else gone thru

> this and if so, does this all sound correct? Are there any other

> options? I am certainly not pleased that Aubrey will have to be

> intubated to have this done after all the work we have been thru due to

> her intubations when she was younger.

did not have a drain tube. When was decannulated, they kept him

inpatient overnight to observe him. For the closure he was an out-patient

and came home the same day. Our ENT did not mention anything about an

oxygen bubble - but perhaps there is some third variable at play here that

we are unaware of - either that or was very very lucky. Actually, I

do believe that IS very very lucky.

> Bradley

> Father to Aubrey (3.5 years old with charge, Ian 9 years, 3

> months, and husband to )

>

I apologize for the delay in my reply - I hope all goes well for you and

your family and Aubrey. Decannulation was very very exciting in our family,

but the closure was magic. Decannulation was allowing the discussion of not

needing the trach, but the closure made it physically real. Now when I look

at I either forget he ever had the trach or I still think he has it.

But when I look at pictures of him with the trach, it looks odd - almost

like someone had drawn a mustache on his face!

Best of everything-

Yuka Persico