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Published on: April 1, 2019
Management of the post-tracheostomy scar
Nazaneen Grant1, Steven P Davison
1Department of Otolaryngology-Head & Neck Surgery, Georgetown University Hospital, Washington, DC 20007, USA. nazaneengrant@yahoo.com
The Laryngoscope
|October 9, 2007
Summary
Effective tracheostomy scar revision involves restoring tissue, releasing skin tug, and achieving tension-free closure. These reconstructive principles improve contour and minimize visible scarring in the neck.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Scar Management
Background:
- Tracheostomy scars can lead to aesthetic concerns and functional issues like tracheal skin tug.
- Management aims to restore deep tissue, correct skin adherence, and achieve natural-looking closure.
Observation:
- Presents three cases illustrating key principles for tracheostomy scar correction.
- Highlights techniques including layer re-approximation, tissue deficit filling, and scar excision.
Findings:
- Reconstructive principles address contour, tissue deficit (using flaps or grafts), hypertrophic scarring, and wound closure (z-plasty).
- Successful application resolves skin adherence and improves scar appearance.
Implications:
- Outlined techniques offer solutions for challenging tracheostomy scars.
- Improved scar appearance and function can enhance patient quality of life.
Related Concept Videos
01:16Tracheostomy Care I: Pre-procedural Steps
A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
The equipment necessary for tracheostomy care includes:
Required Equipment
The equipment necessary for tracheostomy care includes:
01:21Tracheostomy Decannulation
Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
01:25Tracheostomy Care II: Procedure
Tracheostomy care is an essential nursing skill that involves cleaning and maintaining a tracheostomy tube to prevent infection and other complications. Here's a step-by-step guide explaining each procedure with its rationale. Note that disposable gloves are to be worn at all times and changed as often as needed to maintain a sterile work environment, and to protect both patient and healthcare worker.
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask and...
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask and...
01:28Tracheostomy: Procedure and Tubes
A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
01:24Healing II: Complications
Complications during healing arise when tissue repair is altered by local or systemic factors. These changes involve abnormal collagen deposition, altered biomechanics, and reduced vascular supply, impairing restoration of normal structure and function.Loss of FunctionScar tissue differs significantly from the original tissue it replaces. In the skin, fibrosis lacks adnexal structures such as hair follicles, sebaceous glands, and sweat glands. Their absence reduces tactile sensitivity, impairs...
01:23Oxygen Delivering System III: Tracheostomy and T-piece
Oxygen delivery is critical in clinical care, especially for patients with respiratory disorders or those undergoing surgical procedures. Various systems, such as tracheostomy and the T-piece, deliver oxygen to the lungs, ensuring adequate arterial oxygenation.
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...