Evaluation of Post-tracheostomy`s Scars and its Impact on Persons Quality of Life: A Case Control Study

Abstract

Background: Tracheostomy is one of the more commonly performed procedures in critically ill patients. Postoperative scarring is one of the bothersome sequelae of tracheostomies. Scars distorted the physical appearance, especially when found on the head and neck, which could cause a negative impact on quality of life. The aim of this study was to evaluate and assess the impact on quality of life of post-tracheostomy`s scars, depending on the method of tracheostomy.Methods: The prospective, single-center observational case-control study was conducted. One hundred and fifty-six persons with more than four months of post-tracheostomy surgical scars presence were observed using the Patient and Observer Scar Assessment Scale and Dermatology Life Quality index questionnaire. Persons were divided on two groups depending on method of performed tracheostomy, and duration of cannulated period was considered in both groups. Statistical analyses were performed by using SPSS ver. 16.0 (SPSS Inc., Chicago, IL, USA) and p-values of <0.05 were considered significant.Results: The patients who had a tracheostomic tube cannulation period of less than 15 days had better cosmetic results than those who had tracheostomic tubes for more than 15 days, regardless of the method of tracheostomy 6.64± 0.082 vs. 16.15± 0.096 (p<0.001) in surgical tracheostomy group and 7.26± 0.211 vs.14.17± 0.379 (p<0.05) in percutaneous dilatational group. The Dermatology Life Quality index scores have shown a mean value of 0.6 ±0.01, which means that post-tracheostomy scarring in the presented study, had no effect on the person's quality of life.Conclusions: Aesthetic outcomes of post-tracheostomy`s scars after the open surgical tracheostomy technique, performed using a minimally invasive approach, did not statistically differ from those of the percutaneous dilatational technique. Persons with a long duration of tracheostomic tube ventilation showed worse aesthetic outcomes compared with short-term tracheostomic cannulation, not dependent on the tracheostomy performing technique.The Dermatology Life Quality index have shown that post-tracheostomy`s scarring in the presented study had no effect on the person's quality of life.Trial registration: ISRCTN24668317 (IRB no.YSMU №7/18-19). Date of registration 23/04/2019