31830 Revision of tracheostomy scar

Name of the Procedure:

Revision of Tracheostomy Scar
Common name(s): Tracheostomy scar revision, Tracheal scar excision, Tracheostomy site correction
Technical/medical term: Tracheostomy scar revision

Summary

Tracheostomy scar revision is a surgical procedure to improve the appearance or function of a scar left from a previous tracheostomy—a surgical opening made in the windpipe to aid in breathing. This revision can be performed to enhance the cosmetic look of the scar or to resolve issues like discomfort and restricted neck movement.

Purpose

The procedure addresses complications or unsatisfactory appearance of a tracheostomy scar.
Goals include:

• Improving scar aesthetics
• Alleviating discomfort or pain
• Restoring normal neck movement
• Enhancing overall skin function at the scar site

Indications

• Noticeable or unsightly scarring
• Pain or discomfort at the scar site
• Impaired movement of the neck or adjacent areas
• Skin complications such as keloids or hypertrophic scars
• Patient dissatisfaction with the scar’s appearance

Preparation

• Fasting for 6-8 hours prior to surgery if general anesthesia is used
• Possible cessation of certain medications as advised by the doctor
• Pre-operative physical examination and medical history review
• Imaging or tests (e.g., X-rays, blood tests) as deemed necessary

Procedure Description

1. Administration of local or general anesthesia.
2. The surgeon makes an incision around the existing tracheostomy scar.
3. The scar tissue is carefully removed or revised.
4. The surrounding skin is then re-draped and sutured to minimize scarring.
5. A dressing is applied to protect the area.

Tools/Equipment:

• Scalpel
• Surgical scissors
• Suturing materials
• Sterile dressings

Anesthesia: Local or general anesthesia, depending on the extent of the revision.

Duration

Typically 1-2 hours.

Setting

Performed in a hospital operating room or an outpatient surgical center.

Personnel

• Surgeon
• Surgical nurses
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

Common risks:

• Infection
• Bleeding
• Swelling
• Bruising Rare risks:
• Poor wound healing
• Recurrence of excessive scarring (keloids or hypertrophic scars)
• Nerve damage

Benefits

• Enhanced cosmetic appearance of the scar
• Relief from pain or discomfort
• Improved neck mobility
• Increased patient confidence and satisfaction

Expected benefits are often seen gradually as the surgical site heals over several weeks.

Recovery

• Keep the surgical site clean and dry.
• Follow the surgeon’s instructions regarding wound care and activity restrictions.
• Take prescribed medications to manage pain or prevent infection.
• Attend follow-up appointments to monitor healing.

Expected recovery time: 1-2 weeks for initial healing, with several months for full scar maturation.

Alternatives

• Non-surgical scar treatments (e.g., corticosteroid injections, silicone sheeting)
• Laser therapy
• Dermabrasion

Each alternative has its own pros and cons, such as varying levels of effectiveness, cost, and recovery times.

Patient Experience

During the procedure, the patient may feel some pressure or mild discomfort if local anesthesia is used, but pain should be minimal. Post-procedure, there may be swelling, bruising, and discomfort, which can be managed with medications and proper care. Most patients experience significant improvement in scar appearance and associated symptoms over time.