Tracheostomy scar management by repositioning platysma muscle and applying an acellular dermal substitute

Head Neck. 2019 Aug;41(8):2671-2675. doi: 10.1002/hed.25745. Epub 2019 Mar 21.

Abstract

Background: A depressed tracheostomy scar can be esthetically unacceptable. We describe a new technique for managing tracheostomy scars using platysma muscle repositioning and the application of an acellular dermal substitute.

Methods: Seventeen patients with depressed tracheostomy scars were identified for scar management. The time between tracheostomy tube removal and scar management was 29 months. Before and after the surgery, the scar was rated using the Vancouver Scar Scale (VSS).

Results: After surgery, tracheal tug was eliminated in all patients and the appearance of the scar was much improved. The mean total VSS score improved from 8.265 to 2.324 (P < 0.0001). The follow-up period was 33.3 months.

Conclusions: The management of tracheostomy scars by repositioning platysma muscle and applying an acellular dermal substitute is simple and efficient. The technique recovers the lost deep tissue volume, corrects tracheal skin tug, and enables tension-free skin closure to restore the normal contour of the neck.

Keywords: acellular dermis; neck; platysma; scar; tracheostomy.

MeSH terms

  • Adult
  • Cicatrix / classification
  • Cicatrix / etiology
  • Cicatrix / surgery*
  • Esthetics
  • Humans
  • Male
  • Middle Aged
  • Plastic Surgery Procedures / methods
  • Skin, Artificial*
  • Superficial Musculoaponeurotic System / transplantation*
  • Tracheostomy / adverse effects*
  • Young Adult