Primary repair of the trachea should be carried out with:
A. Wire sutureInjuries of the trachea are repaired with a running 3-0 absorbable monofilament suture. Tracheostomy is not required in most patients. Esophageal injuries are repaired in a similar fashion. If an esophageal wound is large or if tissue is missing, a sternocleidomastoid muscle pedicle flap is warranted, and a closed suction drain is a reasonable precaution. The drain should be near but not in contact with the esophageal or any other suture line. It can be removed in 7 to 10 days if the suture line remains secure. Care must be taken when exploring the trachea and esophagus to avoid iatrogenic injury to the recurrent laryngeal nerve.