Percutaneous tracheostomy, a technique that can be performed at the be
dside in the intensive care unit (ICU), is increasingly used for criti
cally ill ventilator-dependent patients. Based on many clinical studie
s, this procedure appears to be simple, rapid and safer than conventio
nal surgical tracheostomy. This technique produces a stoma tissue trac
t that fits snugly around the cannula, and this could explain the low
incidence of infective complications. However, we report two cases of
life-threatening cellulitis, a serious complication that has rarely be
en reported previously.