ENT and Maxillofacial Surgery Department, Yerevan State Medical University, "Heratsi" №1 University Hospital, Yerevan, Armenia.
Administrative Department, Yerevan State Medical University, Yerevan, Armenia.
Int Wound J. 2023 Feb;20(2):372-380. doi: 10.1111/iwj.13885. Epub 2022 Jul 7.
Tracheostomy is one of the more commonly performed procedures in critically ill patients under mechanical ventilation. Postoperative scarring is one of the bothersome sequelae of tracheostomies. Scars distort physical appearance, especially when found on the head and neck, which could have a negative impact on quality of life. The aim of this study was to evaluate and assess the impact of post-tracheostomy scars on quality of life according to the tracheostomy method. A prospective, single-center, observational, case-control study was conducted. One hundred fifty-six persons with a post-tracheostomy surgical scar for more than four months were observed using the Patient and Observer Scar Assessment Scale and Dermatology Life Quality Index questionnaire. Persons were divided into two groups depending on the method of tracheostomy, and the duration of the cannulated period was considered in both groups. Statistical analyses were performed using SPSS ver. 16.0 (SPSS Inc., Chicago, IL, USA), and P values of <0.05 were considered significant. The patients who had a tracheostomic tube cannulation period of fewer than 15 days had better cosmetic results than those who had tracheostomic tubes for more than 15 days, regardless of the tracheostomy method: 6.64 ± 0.082 versus 16.15 ± 0.096 (P < 0.001) in the surgical tracheostomy group and 7.26 ± 0.211 versus 14.17 ± 0.379 (P < 0.05) in the percutaneous dilatational group. The Dermatology Life Quality Index scores had a mean value of 0.6 ± 0.01, which means that post-tracheostomy scarring in the present study had no effect on the person's quality of life. The aesthetic outcomes of post-tracheostomy scars after the open surgical tracheostomy technique did not significantly differ from those of the percutaneous dilatational technique in the present study. Persons with a long duration of tracheostomic tube ventilation showed worse aesthetic outcomes than those with short-term tracheostomic cannulation, which was not dependent on the tracheostomy technique. The Dermatology Life Quality Index showed that post-ttracheostomy scarring in the present study had no effect on the person's quality of life.
气管切开术是机械通气的危重症患者中较常进行的手术之一。术后瘢痕是气管切开术的一种令人烦恼的后遗症。瘢痕会改变外观，尤其是在头颈部发现时，这可能会对生活质量产生负面影响。本研究旨在根据气管切开术方法评估和评估气管切开术后瘢痕对生活质量的影响。进行了一项前瞻性、单中心、观察性、病例对照研究。观察了 156 名气管切开术后手术瘢痕超过 4 个月的患者，使用患者和观察者瘢痕评估量表和皮肤病生活质量指数问卷。根据气管切开术方法将患者分为两组，并考虑两组的套管插入时间。使用 SPSS ver.16.0（SPSS Inc.，芝加哥，IL，USA）进行统计分析，P 值<0.05 被认为具有统计学意义。与气管切开管插入时间超过 15 天的患者相比，气管切开管插入时间少于 15 天的患者具有更好的美容效果，无论气管切开术方法如何：手术气管切开组为 6.64±0.082 与 16.15±0.096（P<0.001）；经皮扩张组为 7.26±0.211 与 14.17±0.379（P<0.05）。皮肤病生活质量指数评分的平均值为 0.6±0.01，这意味着本研究中的气管切开术后瘢痕对人的生活质量没有影响。本研究中，开放式手术气管切开术与经皮扩张术的术后瘢痕美观效果无显著差异。气管切开管通气时间较长的患者的美观效果不如短期气管切开管插管的患者，这与气管切开术技术无关。皮肤病生活质量指数显示，本研究中的气管切开术后瘢痕对人的生活质量没有影响。
