Figure 1.

Surgical repair for Patient No.8 with tracheocutaneous fistula. (A) The TCF size was measured around 10 mm. (B) Dissection proceeded through to the peritracheal area, preserving an area of fibrotic subcutaneous tissue around the fistula (yellow arrows). (C) The hinged turnover flaps were sutured with 4-0 polydioxanone to make an inner lining for the trachea to cover the tracheal lumen with skin epithelium (yellow arrows). (D) The subcutaneous tissues around the fistula were then sutured with 4-0 vicryl using multiple layered sutures to invaginate the hinged flaps into the fistula (yellow arrows).