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Narmada, Steven

Yayasan Lingkar Studi Bedah Plastik

Author-ID : 1016120

Civil Engineering, Building, Construction & Architecture Other

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Articles

Giant Abscess On Serve Leprosy Reaction With Prolong Used Of Steroid Narmada, Steven; Hasibuan, Lisa Y
Jurnal Plastik Rekonstruksi Vol. 2 No. 4 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Abstract: Leprosy patients during the course of their illness may experience the leprosy reactions, the body's immune response against Mycobacterium leprae. Long-term use of steroids for treatment may decrease the body's immune system against Mycobacterium leprae. As severe leprosy reactions, giant abscess incidence is rare and has a high morbidity and motality. Therefore, it needs a comprehensive multidisciplinary management such multiple incision and drainage, proper pharmacologic treatment for leprosy reactions as underlying disease that involves the patient's systemic condition. Patient and Method: We report one case of giant abscess in bucal, left upper and lower extremities in leprosy patients who had been taking steroids for 1.5 years due to neuritis (Paucibacillary leprosy reaction type) but the leprosy reactions became more severe and the patient's condition deteriorated. We performed multiple incision through subcutaneus and fascia to expose each compartmens of muscle and drainage to remove pus. Result: There were 2,500 cc of pus in the left femoral region and 200 cc in the left antebrachial region. The culture was negative, showing that the giant abscess was not caused by bacterial infection, but a severe leprosy reactions. Systemic complications due to leprosy reactions, the longterm use of steroids and hypoalbuminemia prevent wound healing and patient’s recovery. Summary: Long-term use of steroids in leprosy may weaken the immune system and cause a giant abscess. Therefore we need a comprehensive management of multiple surgical incision and drainage as well as medical treatment and proper nutritional support.

Factors Associated with Occurrence of Amputation in Electrical Burns Narmada, Steven; Hasibuan, Lisa Y
Jurnal Plastik Rekonstruksi Vol. 2 No. 4 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Electrical burns can cause damage to blood vessels in the burning extremities . This damage can lead to amputation that significantly impacts both physically and psychologically that affects the quality of life. This study aimed to determine the incidence and factors associated with the occurrence of amputation in electrical burns. Method: A retrospective cohort study was done to patients with electrical burns that came to RSHS from 2011 to 2013. Mulativariate analysis, logistic regression, was performed on the factors associated with the occurrence of amputation in electrical burns. Result: Most of the electrical burns were suffered by men (93.5%) at reproductive age (mean 34.1 years; range 10-60 years of age). The incidence of amputation in electrical burns is 54.8% from 31 patients. There is a significant relationship between the causes of high-voltage electrical burns> 1000V with the occurrence of amputation (p = 0.008; Relative risk ratio 8,125 ; 95% CI= 1,62-40,752) and there is a significant relationship between the presence of third degree of burns with amputation (p = 0,011; Relative risk ratio 16; 95 % CI=1,643-155,76). There is no significant relationship between the extent of burns and lactate levels with the amputation on electrical burns. Conclusion: Amputation in electrical burns have a fairly high incidence. High electrical voltage> 1000V and presence of third degree of burns are associated with the occurrence of amputation.

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