A history of tracheostomy is reported, indicating the relatively recent use of traction sutures. 2. The indications for a tracheostomy are listed. 3. The complications of a tracheostomy are mentioned briefly with emphasis on tube displacement and how this provides the rationale for the use of traction sutures. 4. The technique of placement of the traction sutures with the use of a new instrument, the ligature passer, is described. 4. An illustrative case is reported to demonstrate the significance of traction sutures.
