TRACHEOSTOMY may be of value in the care of a burn patient.1If a tracheostomy is necessary it is usually done to (1) bypass edema and swelling of the glottis or soft tissue about the airway; (2) treat edema of the tracheobronchial tree and increased secretions following inhalation of irritant smoke and gases; (3) relieve the patient of retained secretions when there is dysfunction of the cough reflex, and (4) administer general anesthesia.2, 3In general, "the awareness for the need of a prophylactic tracheostomy minimizes the necessity for tracheostomy as an emergency procedure,"4thus providing enough time for a careful operation. The hazards of high tracheostomy, primarily laryngeal stenosis, have been widely discussed.5, 6Only brief mention has been made of the dangers associated with low tracheal incision.7-9At the United States Army Surgical Research Unit, a burn referral center, most of the patients