The pediatric tracheostomy stoma can be matured via a technique that places
4-quadrant sutures from the tracheal cartilage to the dermis. This has the
potential of decreasing the risk of accidental decannulation and the forma
tion of granulation tissue. A retrospective analysis of 149 tracheostomies
performed between January 1989 and December 1996 was done for the following
factors: age, underlying diagnosis, indication for tracheostomy, type of t
racheal incision, maturation of stoma, duration of tracheostomy, and early
and late (>7 days) complications. Maturation of the stoma was performed in
88 (59.1%) of the 149 tracheostomies. There was an overall complication rat
e of 21.5% (32/149, not including granulation tissue formation). There were
9 (6.0%) early complications and 23 (15.4%) late complications. The overal
l incidence of tracheocutaneous fistulas occurred in 11 (11.2%) of the 98 d
ecannulated patients: 6 (10.2%) of the 59 matured stomas and 5 (12.8%) of t
he 39 nonmatured stomas. Granulation tissue was found on subsequent laryngo
scopy in 24 (27.3%) of the ss matured stomas versus 23 (37.7%) of the 61 no
nmatured stomas. There were no tracheostomy-related mortalities. Maturing t
he tracheostomy stoma resulted in a decreased morbidity from accidental dec
annulations and did not increase the incidence of tracheocutaneous fistulas
or granulation tissue formation.