BACKGROUND: Tracheotomy is a life-saving operation but may have bothersome sequelae. Because the defect resulting from tracheostomy is often allowed to repair spontaneously by secondary intention, hypertrophic scar formation is a frequent consequence. Furthermore, skin-to-trachea adhesions may develop, creating a "tracheal tug," that is, the skin movement in conjunction with the trachea, causing discomfort on swallowing. The aim of this study was to verify whether lipofilling could treat the aesthetic and functional disturbances by remodeling tracheostomy scars. METHODS: Ten patients, aged 20 to 51 years, with retracted and/or hypertrophic tracheostomy scar underwent fat injection under local anesthesia or sedation. Fat harvesting was by a 2-mm blunt cannula connected to a 10-mL syringe. Before inserting the refined fat with a 19-gauge cannula, the fibrotic bands of the retracted scar between skin and underlying tissue were released with a sharp needle. The procedure required 2 sessions with an interval of 6 to 12 months. In the first session, 3.0 to 10 mL of fat were inserted. A further 3 to 5 mL were delivered during the second course. In 3 cases, scar excision was performed under local anesthesia as a final procedure. RESULTS: All 10 patients achieved an aesthetic and functional improvement and were satisfied with the result at long-term follow-up (mean, 21.3 months). CONCLUSIONS: Fat grafting proved to be a safe, minimally invasive, and effective procedure for the treatment of the tracheostomy scar both for functional and aesthetic purposes. It can be considered as a valid alternative to major open surgery.
BACKGROUND: Tracheotomy is a life-saving operation but may have bothersome sequelae. Because the defect resulting from tracheostomy is often allowed to repair spontaneously by secondary intention, hypertrophic scar formation is a frequent consequence. Furthermore, skin-to-trachea adhesions may develop, creating a "tracheal tug," that is, the skin movement in conjunction with the trachea, causing discomfort on swallowing. The aim of this study was to verify whether lipofilling could treat the aesthetic and functional disturbances by remodeling tracheostomy scars. METHODS: Ten patients, aged 20 to 51 years, with retracted and/or hypertrophic tracheostomy scar underwent fat injection under local anesthesia or sedation. Fat harvesting was by a 2-mm blunt cannula connected to a 10-mL syringe. Before inserting the refined fat with a 19-gauge cannula, the fibrotic bands of the retracted scar between skin and underlying tissue were released with a sharp needle. The procedure required 2 sessions with an interval of 6 to 12 months. In the first session, 3.0 to 10 mL of fat were inserted. A further 3 to 5 mL were delivered during the second course. In 3 cases, scar excision was performed under local anesthesia as a final procedure. RESULTS: All 10 patients achieved an aesthetic and functional improvement and were satisfied with the result at long-term follow-up (mean, 21.3 months). CONCLUSIONS: Fat grafting proved to be a safe, minimally invasive, and effective procedure for the treatment of the tracheostomy scar both for functional and aesthetic purposes. It can be considered as a valid alternative to major open surgery.
Authors: Abdullah A Al Qurashi; Ahmed Kamal Siddiqi; Abdulrahman Abdulaziz Alghamdi; Abdullah Ali N Aljalfan; Ahmed Abdullah Almenhali; Faisal Ali Al Jabr; Ahmed Mustafa Rashid; Talal Almas; Ritesh G Menezes Journal: Aesthetic Plast Surg Date: 2022-04-11 Impact factor: 2.326
Authors: Linda Vriend; Joris A van Dongen; Anouk Pijpe; Marianne K Nieuwenhuis; Sandra J M Jongen; Martin C Harmsen; Paul P M van Zuijlen; Berend van der Lei Journal: Trials Date: 2022-07-19 Impact factor: 2.728
Authors: Maroesjka Spiekman; Joris A van Dongen; Joep C Willemsen; Delia L Hoppe; Berend van der Lei; Martin C Harmsen Journal: J Tissue Eng Regen Med Date: 2017-02-03 Impact factor: 3.963
Authors: Felix Grambow; Rico Rutkowski; Fred Podmelle; Katrin Schmoeckel; Florian Siegerist; Grzegorz Domanski; Matthias W Schuster; Grazyna Domanska Journal: Int J Mol Sci Date: 2020-04-20 Impact factor: 5.923