Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo, Japan.
Trauma and Reconstruction Center, Shinyurigaoka General Hospital, Kanagawa, Japan.
Int Wound J. 2023 Sep;20(7):2499-2504. doi: 10.1111/iwj.14110. Epub 2023 Feb 2.
Tracheocutaneous fistula and tracheostomy scar are complications associated with the prolonged use of tracheostomy tubes. They have functional and cosmetic problems owing to tracheal tugging during swallowing and easily visible scars. Although many procedures exist to correct this issue, there is no consensus on the optimal surgical technique. Therefore, an ideal surgical procedure was devised. The study was performed on 12 patients between September 2016 and May 2021. All patients had persistent tracheocutaneous fistulas or hypertrophic scars on the neck after tracheostomy. All procedures were performed using a hinged flap and two myocutaneous local flaps. All patients had no complications, and their aesthetics were excellent in postoperative photographs. The scar was better on the straight scar when the flap's skin is denuded than on the VY advancement flap. It should be noted, however, that this procedure can cause the flap to become congested in a short period after head and neck surgery. This procedure is safe, reliable and simple for surgical closure. This was found to produce excellent cosmetic results with no major complications.
气管-皮肤瘘和气管造口瘢痕是与气管造口管长期使用相关的并发症。由于吞咽时气管牵拉和可见的明显瘢痕,它们存在功能和美观问题。尽管有许多方法可以纠正这个问题,但对于最佳手术技术尚无共识。因此,设计了一种理想的手术方法。该研究于 2016 年 9 月至 2021 年 5 月对 12 名患者进行。所有患者在气管造口后颈部均有持续的气管-皮肤瘘或肥厚性瘢痕。所有手术均使用铰链皮瓣和两个肌皮局部皮瓣。所有患者均无并发症,术后照片显示其美观效果极佳。皮瓣去表皮后直瘢痕的瘢痕比 VY 推进皮瓣好。然而,应该注意的是,这种手术会导致头颈部手术后短时间内皮瓣充血。该手术是一种安全、可靠和简单的手术闭合方法。结果发现,这种方法产生了极好的美容效果,没有出现重大并发症。