Crude tracheotomies have been depicted on Egyptian artefacts as far back as 3600BC1, while the ancient Syrians used catheters fashioned from reeds. Percutaneous devices are now in common use in clinical practice over a wide range of therapy areas. These devices create a wound (exit site) that needs to be managed appropriately to prevent complications, such as infection or overgranulation. Elective management of an exit site wound can be challenging, although the risks can be reduced by adopting principles of good basic care, close observation and appropriate patient and carer education.