Correction of tracheo-cutaneous adhesion after tracheostomy

Tracheostomy is indicated for various situations to secure airway. After decanulation, the secondary intention is regularly employed and contraction of tissue will lead to heal. Frequently, an indented scar remains. Simple revision of the scar or classic Poulard’s method of burying deepithelized scar is utilized to ease the cosmetic problems. Though in some severe cases, re-adhesion of trachea and cervical skin occurs, because of the lack of soft tissue between them. Tight contracture burden patients with pain in phonation and swallowing. A simple procedure of turning over dermal-fat flaps, to augment subcutaneous tissue between trachea and overlying skin, was applied to five cases. All procedures were performed under local anaesthesia. The procedure could solve the functional problems with acceptable cosmetic results. Correspondence to: Dr. Soh Nishimoto, Department of Plastic Surgery, Hyogo College of Medicine, Mukogawa-cho, Nishinomiya, Hyogo, Japan; Tel: 81-79845-6753; Fax: 81-798-45-6975; E-mail: nishimot@hyo-med.ac.jp