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The development of stenosis at the suture line after tracheal resection and end-to-end anastomosis of the trachea is associated with failure to approximate the tracheal ends. Evidently, stenosis invariably will occur if the viable mucosal edges are not properly adapted to each other. We developed a method of anastomosis affording accurate approximation of the tracheal ends and particularly of the mucosa by doing Z-plasties in the mucosa. This method of tracheal anastomosis, which is comparatively easy and safe to perform, may be used reliably and without the development of mucosal structures. more...

The flap tracheostomy was studied in 25 adult canines to further investigate its best management. Tracheostomies were performed by employing the inverted U flap incision in the trachea. After decannulation, the flap was either formally resewn to the trachea, bluntly dissected from the surrounding soft tissues, or left in place. The time required for epidermal closure over the tracheostomy site was measured, along with fixation of skin to soft tissues in the area. Histologic examinations were made, and tracheal dimensions were calculated on sections through the stomal area. More rapid skin closure and less soft tissue fixation occurred in animals that underwent resuturing or release of the tracheal flap. In all groups, cartilage viability and regrowth were noted. Tracheal diameters were maintained in all groups, but smoother contouring was seen with resuturing. Additional support for the flap tracheostomy is provided from this animal experimentation. more...