Primary vs Secondary Closure of Tracheo-cutaneous Fistulas

This study compares two methods of closing a tracheostomy site — the hole in the throat left after a breathing tube (tracheostomy cannula) is removed. One method is primary closure, where the wound is surgically stitched closed. The other is secondary (natural) closure, where the wound is left to heal on its own. Both are used in practice, but it is not yet clear which produces better outcomes in terms of healing time, scarring, and complications. Patients whose tracheostomy is ready to be removed will be randomly assigned to one of the two closure methods, and their healing will be monitored over time. **You may be eligible if you:** - Are covered by RAMQ (Quebec's provincial health insurance) - Have had a tracheostomy (either percutaneous or surgical) - Are clinically ready to have the cannula removed and the tracheostomy site closed **You may NOT be eligible if you:** - Have a contraindication to primary tracheostomy closure (such as granuloma tissue formation at the site) - Are unable to provide informed consent - Do not wish to participate **Talk to your doctor** if you are approaching the stage of tracheostomy removal and want to understand your options for wound closure.