Criteria for conservative (nonoperative) management – all of the following:
(1) small tracheobronchial laceration(s)
(2) injury involves less than one third of the circumference of the airway
(3) the edges of the injury are well-opposed
(4) there is no tissue loss
(5) there are no other associated injuries
(6) positive pressure ventilation is not required
Management if conservative approach:
(1) humidify air
(2) voice rest
(3) frequent suctioning
(4) prophylactic antibiotics
(5) proton pump inhibitor
(6) close observation, with follow-up bronchoscopy
If one or more of the criteria are not met, then operative repair is indicated, which involves:
(1) debriding damaged tissue and evacuate any hematoma
(2) end-to-end anastomosis, tension free and with preservation of blood supply
(3) continuous running sutures using monofilament sutures, with knots on the outside
