Archives of Craniofacial Surgery (대한두개안면성형외과학회지)

Korean Cleft Palate-Craniofacial Association (대한두개안면성형외과학회)
권호 표지
DOI QR코드

DOI QR Code

Four-layer technique for tracheostomy scar treatment

  • Jae Kyoung Kang (Department of Plastic and Reconstructive Surgery, Jeju National University College of Medicine) ;
  • Byung Min Yun (Department of Plastic and Reconstructive Surgery, Jeju National University College of Medicine)
  • Received : 2023.09.22
  • Accepted : 2023.12.20
  • Published : 2024.06.20
Download PDF
⟨ Previous Next ⟩

Abstract

One important complication of the tracheostomy procedure is the depressed scar left after the tube is removed. A depressed tracheostomy scar can be aesthetically and functionally unacceptable. Tracheostomy scar treatment aims to fill lost soft tissue volume and correct tracheal skin tug. There are various techniques described to manage post-tracheostomy scars, including the use of autologous tissue or allogenic material and the creation of muscle flaps. In this article, the authors introduce a surgical method using four layers: the scar, the strap muscles, the platysma muscle, and the skin. This procedure has been used in two patients with depressed scar after prolonged tracheostomy placement. The tracheal tug was eliminated in each patient, and an imperceptible cutaneous scar remained. In each case, patient satisfaction was complete. The authors recommend this technique as a simple and effective method of closure for these troublesome tracheostomy scars.

Keywords

Acknowledgement

This work was supported by the 2024 Education, Research and Student Guidance Grant funded by Jeju National University

References

  1. Pressman JJ. The repair of depressed tracheotomy scars. Arch Otolaryngol 1961;74:150-2. 
  2. Lewin ML, Keunen HF. Revision of the posttracheotomy scar: correction of the depressed, retracted scar. Arch Otolaryngol 1970;91:395-7. 
  3. Kulber H, Passy V. Tracheostomy closure and scar revisions. Arch Otolaryngol 1972;96:22-6. 
  4. Oztiurk S, Aksu M, Sengezer M. Split sternocleidomastoid muscle repositioning for correction of depressed post-tracheostomy scar and tracheal tug. Ann Plast Surg 2004;53:240-4. 
  5. Grant N, Davison SP. Management of the post-tracheostomy scar. Laryngoscope 2007;117:2107-9. 
  6. Kurt Yazar S, Yuce E, Serin M, Yazar M, Gul Z, Irmak F, et al. A new technique in management of depressed posttracheostomy scars. Ann Plast Surg 2018;81:311-5. 
  7. Choi Y, Lee JH, Kim YH, Lee YS, Chang HS, Park CS, et al. Impact of postthyroidectomy scar on the quality of life of thyroid cancer patients. Ann Dermatol 2014;26:693-9. 
  8. Carlson ER, Marx RE, Jones GM. Tracheostomy scar revision using allogeneic dura. J Oral Maxillofac Surg 1991;49:315-8. 
  9. Skigen AL, Bedrock RD, Stopperich PS. Correction of the depressed, retracted, post-tracheostomy scar. Plast Reconstr Surg 1999;103:1703-5. 
  10. Aitken ME, Hammond DC. Double-muscle flap repair of the tethered tracheostomy scar. Ann Plast Surg 2002;49:328-32. 
  11. Ha JH, Kim SW. Tracheostomy scar management by repositioning platysma muscle and applying an acellular dermal substitute. Head Neck 2019;41:2671-5.