{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T15:53:26Z","timestamp":1768838006622,"version":"3.49.0"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"06","license":[{"start":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T00:00:00Z","timestamp":1718755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Plast Surg"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Most tracheostomy scars are depressive and adherent to the underlying trachea, which causes up and down movement when swallowing. This tracheocutaneous tethering causes discomfort, pain, dysphagia, and bad appearance. A tracheocutaneous fistula may be accompanied. Here, we present a new method for reconstructing a tracheostomy scar deformity with tracheocutaneous tethering: layer-by-layer restoration of the anatomical structure with a subcutaneous fat tissue blanket. The scar tissue was fully excised, with the associated skin and subcutaneous tissue. The bilateral strap muscles around the scar were dissected proximally and distally and approximated to the midline, secured without tension. Bilateral platysma muscle flaps cover them firmly. The subcutaneous tissue around the incision margin, which included the superficial cervical fascia was elevated to form a fat blanket, closed transversely. The skin was closed after confirming the absence of retraction upon swallowing. From 2010 to 2018, 10 patients with tracheocutaneous tethering and one patient with tracheocutaneous fistula underwent surgery. All patients were functionally and aesthetically satisfied with the results. The only complication was a hypertrophic scar in one patient, which was managed with a triamcinolone injection. An anatomical layer-by-layer restoration with a fat blanket provided consistent, satisfying results for correcting tracheostomy scar deformities without using additional tissue. This simple method was effective for reconstructing tracheocutaneous tethering.<\/jats:p>","DOI":"10.1055\/s-0044-1787294","type":"journal-article","created":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T23:14:38Z","timestamp":1718838878000},"page":"549-555","source":"Crossref","is-referenced-by-count":1,"title":["Revision of the Retracted Posttracheostomy Scar by Anatomical Restoration; Four Layer Closure"],"prefix":"10.1055","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1451-1824","authenticated-orcid":false,"given":"Jaeyoung","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Kyung Hee University Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9259-1850","authenticated-orcid":false,"given":"Jimin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Kyung Hee University Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6299-6371","authenticated-orcid":false,"given":"Sang Yoon","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Kyung Hee University Hospital, Seoul, Korea"},{"name":"Department of Plastic Surgery, College of Medicine, Kyung Hee University Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,6,19]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1067\/mhn.2000.105714","article-title":"Tracheotomy complications: a retrospective study of 1130 cases","volume":"123","author":"D Goldenberg","year":"2000","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"1572","DOI":"10.1378\/chest.110.6.1572","article-title":"Late complications of percutaneous 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Stanton","year":"2004","journal-title":"J Oral Maxillofac Surg"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1097\/00000637-200209000-00017","article-title":"Double-muscle flap repair of the tethered tracheostomy scar","volume":"49","author":"M E Aitken","year":"2002","journal-title":"Ann Plast Surg"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1001\/archotol.1972.00770090060006","article-title":"Tracheostomy closure and scar revisions","volume":"96","author":"H Kulber","year":"1972","journal-title":"Arch Otolaryngol"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1097\/SAP.0000000000001531","article-title":"A new technique in management of depressed posttracheostomy scars","volume":"81","author":"S Kurt Yazar","year":"2018","journal-title":"Ann Plast 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Surg"},{"issue":"06","key":"ref12","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1097\/00006534-199905000-00021","article-title":"Correction of the depressed, retracted, post-tracheostomy scar","volume":"103","author":"A L Skigen","year":"1999","journal-title":"Plast Reconstr Surg"},{"key":"ref13","first-page":"2","volume-title":"Plastic Surgery. Vol. 3: Craniofacial, Head and Neck Surgery and Pediatric Plastic Surgery. 4th ed","author":"M A Ahmed","year":"2017"},{"issue":"01","key":"ref14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.cps.2013.09.016","article-title":"Anatomy of the neck","volume":"41","author":"E J Kohan","year":"2014","journal-title":"Clin Plast Surg"},{"issue":"04","key":"ref15","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/j.cps.2018.06.011","article-title":"Understanding deep neck anatomy and its clinical relevance","volume":"45","author":"T G O'Daniel","year":"2018","journal-title":"Clin Plast Surg"},{"issue":"10","key":"ref16","doi-asserted-by":"crossref","first-page":"e1515","DOI":"10.1097\/GOX.0000000000001515","article-title":"Tracheocutaneous fistula closure with turnover flap and polydioxanone plate","volume":"5","author":"J R Bryant","year":"2017","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"06","key":"ref17","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1007\/s00266-016-0708-8","article-title":"Tracheocutaneous fistula closure: comparison of rhomboid flap repair with Z plasty repair in a case series of 40 patients","volume":"40","author":"S Hernot","year":"2016","journal-title":"Aesthetic Plast Surg"},{"issue":"01","key":"ref18","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1186\/s13256-015-0728-z","article-title":"The use of a prefabricated radial forearm free flap for closure of a large tracheocutaneous fistula: a case report and review of the literature","volume":"9","author":"A K Royer","year":"2015","journal-title":"J Med Case Rep"},{"issue":"01","key":"ref19","first-page":"9","article-title":"Tracheocutaneous fistula in patients undergoing supracricoid partial laryngectomy: the role of chronic aspiration","volume":"35","author":"A DE Virgilio","year":"2015","journal-title":"Acta Otorhinolaryngol Ital"},{"issue":"04","key":"ref20","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1177\/1090820X14526406","article-title":"Defining the fat compartments in the neck: a cadaver study","volume":"34","author":"J D Larson","year":"2014","journal-title":"Aesthet Surg J"}],"container-title":["Archives of Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0044-1787294.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T00:33:24Z","timestamp":1732062804000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0044-1787294"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,19]]},"references-count":20,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2024,11,13]]},"published-print":{"date-parts":[[2024,11]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0044-1787294","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2234-6163","2234-6171"],"issn-type":[{"value":"2234-6163","type":"print"},{"value":"2234-6171","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,19]]}}}