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Hambatan Kolonisasi Methicillin Resistant Staphylococcus Aereus oleh Ekstrak Kulit Delima pada Luka Bakar Derajat-2 pada Tikus (INHIBITION OF METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS BACTERIA COLONIZATION ON SECOND DEGREE BURN WOUND IN WISTAR RAT BY US Iswinarno Doso Saputro; Lobredia Zarasade; Revita Widya Prasanti
Jurnal Veteriner Vol 17 No 3 (2016)
Publisher : Faculty of Veterinary Medicine, Udayana University and Published in collaboration with the Indonesia Veterinarian Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (125.184 KB)

Bacterial of Methicillin Resistant Staphylococcus Aureus (MRSA) is a pathogen that plays an importantrole as a nosocomial pathogen. The bacteria can cause outbreaks of nosocomial infection which is becomeserious problems in the management of burns patients because many strains have changed intomultiresistant bacteria to several classes of antibiotics. Treatment of MRSA bacterial infection in burnsis still a problem because its cost is relatively expensive and there is an increased trend of the bacteriaresistance. Therefore, alternatives are needed to deal with these problems. One of the alternatives is byusing topical pomegranate peel extract . This study was aimed to compare the topical administration ofpomegranate peel extract with mupirocin and to evaluate the combination effect of pomegranate peelextract with mupirocin against bacterial colonization of MRSA on the burn wound rat skin. Second degreeof burn was made by placing a nail with length 2 cm and width 2 cm. Before it used, the nail was boiled inboiling water for 10 seconds. Isolates of MRSA bacteria were inoculated on burn wound in male rats strainWistar. The rats were divided into three groups, each group was treated six hours after bacterial inoculation.The first group was given mupirocin on the burn wound; the second group was given topical pomegranatepeel extract, and the third group received a combination of mupirocin with pomegranate peel extracttopically. Swab culture was taken on the third and fifth day post-treatment. The specimen was sent to theMicrobiology Laboratory for microbiological examination to evaluate the efficacy of pomegranate peel extract in inhibiting bacterial colonization of MRSA. Topical pomegranate fruit peel extract significantlyinhibited MRSA bacterial colonization on the rat’s burn wound{p sig.(2-tailed),0,045, P < 0,05). Nosignificant result was found on bacterial count in topical pomegranate fruit peel extract administationcompared to topical mupirocin administration or in combination between topical pomegranate andmupirocin. Topical pomegranate fruit peel extract has antibacterial effect, eventhough it is not moreeffective compared to mupirocin administration or combination between the pomegranate and mupirocin.

Elevated Serum Transaminase (SGOT/SGPT) and Sepsis in Burn Patients in a Tertiary Hospital, Surabaya, Indonesia Iswinarno Doso Saputro; Lobredia Zarasade; Rifqi Kurniawan
Folia Medica Indonesiana Vol. 58 No. 2 (2022): June
Publisher : Universitas Airlangga

Highlights: There is no correlation between the increase of SGOT and sepsis. Correlation between the increase of SGPT and sepsis was significant founded. Abstract: Burns trigger hypermetabolic stress reactions that cause inflammatory responses. When there is a sustained or increased hypermetabolic reaction, the inflammatory response can be life-threatening, such as sepsis, and significantly impact hepatic metabolic function. After burns, varying degrees of liver injury are usually associated with burn severity. This study determined the correlation between elevated serum transaminases (SGOT/ SGPT) and sepsis in burn patients at a tertiary hospital of Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, from January 1, 2018, to December 31, 2020. This was a descriptive-analytic study with a retrospective cohort design. The data in this study included the demography of burn patients, causes of burns, inhalation trauma, burn severity, increased serum transaminase (SGOT/SGPT), mortality, and sepsis. This study found that the correlation between elevated serum transaminases (SGOT/SGPT) and sepsis was determined using the Spearman-Rho Rank statistical test. Burn patients with sepsis in the hospital were dominated by males (65.2%) and mostly aged 26-55 years (69.6%). The flame was found to be the highest cause of burns (80.4%), burn area above 20% (91.3%), the highest level of severity was major burn (91.3%), and no inhalation trauma (54.3%). In this study, there was an increase in SGOT of 69.6% and SGPT of 78.3%, with a mortality rate of 39.1%, with average inpatient days of 24 days. The correlation test between elevated serum transaminase (SGOT) and sepsis showed an insignificant relationship (p = 0.065, p> 0.05) with a correlation coefficient of 0.200. In contrast, the correlation between elevated serum transaminase (SGPT) and sepsis was significant (p=0.006, p<0.05) with a correlation coefficient of 0.296.

QUANTITATIVE MEASUREMENT OF BILATERAL CHEILORRHAPHY: A RETROSPECTIVE STUDY Zarasade, Lobredia; Wulandari, Pratidina; Indri Lakhsmi Putri
Jurnal Rekonstruksi dan Estetik Vol. 5 No. 1 (2020): Jurnal Rekonstruksi dan Estetik, June 2020
Publisher : Universitas Airlangga

Highlights: There were no significant differences in anthropometric measurements across various groups indicating consistent results in these facial parameters. Bilateral cheilorrhaphy using the Djohansjah technique at the Surabaya CLP Center achieved satisfactory symmetry of the lips, nose, and philtrum, with consistent anthropometric measurements in preoperative cleft conditions. Abstract: Introduction: Bilateral cheilorraphy has higher complexity compared to unilateral cheilorraphy. Anthropometric measurements provide nasolabial identification of the surgery result objectively. This study aims to assess the outcome of bilateral cheilorrhaphy with the Djohansjah technique at Surabaya CLP Center. Methods: 26 patients underwent bilateral cheilorrhaphy from January 1 to December 31, 2018, at the Surabaya CLP Center. Anthropometric measurements were performed on control photos one-year post-surgery with the GIMP application (GNU Image Manipulation Software) version 2.10.12 to measure the cupid's bow width ratio, hemilabial length ratio, nasal width ratio, and philtrum ridge length ratio. A statistical analysis was performed using Independent Sample t-Tes and Mann-Whitney Test. Results: An anthropometric size difference test based on preoperative condition was performed. No significant difference of the cupid's bow width ratio, hemilabial length ratio, nasal width ratio, and philtrum ridge length ratio between the group of identical cleft lip and unidentical cleft lip with p > 0.05 was found. Likewise, there was no difference between the identical cleft alveolar and unidentical cleft alveolar, as well as the group with or without cleft palate. Conclusions: Symmetry of lips, nose, and philtrum was achieved with bilateral cheilorrhaphy with the Djohansjah technique at the Surabaya CLP Center and there was no significant difference in cupid's bow width ratio, hemilabial length ratio, nasal width ratio, and philtrum ridge length ratio on preoperative cleft condition.

UMBILICAL RECONSTRUCTION WITH DOUBLE OPPOSING SEMILUNAR FLAP, AN APPEALING RESULTS: A CASE SERIES Muharram, Arif Rahmat; Budi, Agus Santoso; Zarasade, Lobredia; Beta Subakti Nata’atmadja
Jurnal Rekonstruksi dan Estetik Vol. 3 No. 1 (2018): Jurnal Rekonstruksi dan Estetik, June 2018
Publisher : Universitas Airlangga

Highlights: A double opposing semilunar flap has good result for umbilicus reconstruction. A double opposing semilunar ensures a natural appearance and avoids visible scarring while maintaining appropriate depth and size. Abstract: Introduction: Umbilical loss is not a common problem encountered in plastic surgery routine cases. The absence of umbilicus will cause significant effect in total aesthetic appearance of the abdomen, thus making it an essential part of anatomy landmark. Congenital defect, oncologic and abdominoplasty complication are the most often causes, and tremendous psychological trauma will cause patient to seek help. Case Illustration: There are many proposed technique for such reconstruction, based on original scar or wound and final expected shape, of course with their advantages and disadvantages. We used a double opposing semilunar flap for our cases. Along with its technical detail, we will present three cases comprises of the defect after omphalocele scar removal, umbilical endometriosis excision and postcentral abdominal tumor excision. Reports will be presented with preoperative and postoperative result. Discussion: This technique avoids the appearance of scarring and secondary stenosis by hiding the circular scar incision and maintaining its position in the middle of the new form. Conclusion: The reconstruction technique of the umbilicus presented for the anatomical units, provides a very natural look, and generates slight excess of skin on the upper part over time and giving a more graceful appearance.

PENGARUH PLATELET RICH FIBRIN PADA PROSES EPITELISASI LUKA DONOR SKIN GRAFT: STUDI META ANALISIS Zarasade, Lobredia; Hutagalung, Magda Rosalina; Saputro, Iswinarno Doso; Putri, Nadia Tamara
Jurnal Rekonstruksi dan Estetik Vol. 6 No. 1 (2021): Jurnal Rekonstruksi dan Estetik, Juni 2021
Publisher : Universitas Airlangga

Highlights: Bukti preklinik yang dianalisis tidak berpengaruh signifikan dari pemberian platelet-rich fibrin (PRF) pada donor skin graft terhadap kecepatan epitelisasi. Praktisi medis perlu mempertimbangkan dengan hati-hati penggunaan PRF dalam prosedur donor skin graft. Abstrak: Latar Belakang: Kehilangan kulit yang terlalu luas perlu jaringan penutup untuk mengatasinya, salah satu pilihan untuk menutup luka tersebut dengan melakukan tindakan skin grafting. Berdasarkan data IRJ Bedah Plastik Rekonstruksi dan Estetik RSUD Dr. Soetomo dalam 1 tahun (2017-2018) didapatkan pada 26 dari 50 kasus donor skin graft mengalami penyembuhan yang lebih dari waktu penyembuhan normal. Metode penyembuhan luka telah mengalami perkembangan beberapa tahun terakhir, salah satunya mulai dikenal peran platelet-rich fibrin (PRF). Metode: Penelitian ini merupakan penelitian dengan desain meta-analisis yang bersifat kuantitatif. Sumber data dari penelitian ini melalui penelusuran literatur di pencarian elektronik dengan menggunakan keyword pencarian literature. Database yang digunakan adalah Medline dan Pubmed antara tahun 2005-2020. Hasil: Seleksi literatur didapatkan lima studi, dengan tiga studi subjek menggunakan donor split thickness skin graft dan dua studi menggunakan donor free gingival graft. Dalam tiga studi menyebutkan pemberian platelet-rich fibrin (PRF) dapat mempercepat waktu penyembuhan dan epitelisasi. Hasil meta analisis menunjukkan tidak ada perbedaan antara kelompok pemberian platelet-rich fibrin (PRF) dan kelompok kontrol dalam proses epitelisasi pada donor skin graft (summary effect 1,30, 95% CI -0,42–3,02). Kesimpulan: Bukti-bukti preklinik berdasarkan studi meta-analisis ini menunjukkan bahwa tidak ada pengaruh signifikan terhadap pemberian platelet-rich fibrin (PRF) pada donor skin graft dalam kecepatan epitelisasi.

THE OCCURRENCE OF CONTRACTURE AND THE SEVERITY OF BURN INJURIES AMONG BURN PATIENTS TREATED AT DR. SOETOMO GENERAL ACADEMIC HOSPITAL, SURABAYA, INDONESIA (2020-2022) Hamiseno, Gifta Marshanda Qanitah; Iswinarno Doso Saputro; Diah Mira Indramaya; Lobredia Zarasade
Jurnal Rekonstruksi dan Estetik Vol. 9 No. 1 (2024): Jurnal Rekonstruksi dan Estetik, June 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jre.v9i1.52160

Highlights: A robust association was observed between total body surface area (TBSA) and burn injuries, except in the case of elderly individuals. The duration of hospitalization is significantly associated with the occurrence of contracture. Abstract: Introduction: Burn injuries are a worldwide issue and can happen for many reasons, often causing skin damage that leads to deformities and movement difficulties. Many burn patients, up to 50%, experience contractures, which limit movement in areas such as the shoulders, wrists, and torso. Proper management through medicine, surgery, and therapy is crucial for helping these patients. Research at Dr. Soetomo General Academic Hospital is focused on studying the frequency of contractures after burn injuries to improve treatment and prevention methods. Methods: The research used descriptive analytics and gathered data from the Burn Unit at Gedung Bedah Pusat Terpadu (GBPT) and the Plastic Surgery Polyclinic at Dr. Soetomo General Academic Hospital in Surabaya. The study examined 40 eligible patients and assessed variables including burn severity, affected body area, and hospitalization duration. Results: The results showed that the average age of patients was 26.30 years, with 70% of them being male. Only 5% of patients had other health problems, mainly related to hormones. Most burns were caused by fire (37.5%), and many were second-degree burns (42.5%). The percentage of the body affected by burns varied by age: children had around 9.86%, adolescents had around 15.96%, and adults had around 5.25%. Most injuries were on the left arm (67.5%), and many patients stayed in the hospital for a long time (67.5%). Conclusion: All patients developed contractures following burns, irrespective of burn severity. There was a correlation between burn size and severity, except among older patients. Additionally, a notable association was observed between contracture occurrence and prolonged hospitalization.

PENGARUH ORAL N-ACETYLCYSTEIN TERHADAP POLA FAKTOR PERTUMBUHAN ENDOTEL VASKULAR (VEGF) DAN FAKTOR PERTUMBUHAN FIBROBLAS (FGF) PADA MODEL KERETA LISTRIK TIKUS Sintaningrum, Elisabeth Prajanti; Saputro, Iswinarno Doso; Zarasade, Lobredia
Jurnal Rekonstruksi dan Estetik Vol. 5 No. 1 (2020): Jurnal Rekonstruksi dan Estetik, June 2020
Publisher : Universitas Airlangga

Highlights: Kadar rata-rata VEGF pada kelompok tikus yang menerima NAC lebih tinggi daripada kelompok kontrol. Hasil FGF pada kelompok tikus kontrol lebih tinggi pada hari ke-0 dan hari ke-8 dibandingkan dengan kelompok tikus yang menerima NAC. Di dalam kadar FGF dan VEGF tidak ada perbedaan yang signifikan antara kelompok yang menjalani perlakuan dan kelompok kontrol negatif. Abstrak: Latar Belakang: Luka bakar listrik menyebabkan cedera serius dengan mortalitas 20-30% dan 74% korban selamat dengan cedera permanen dan sekuel. Tingkat nekrosis pada luka bakar seringkali sulit untuk ditentukan karena sirkulasi mikrovaskuler pada jaringan dalam terlibat. N- acetylcysteine (NAC) dapat mengatasi stres oksidatif dan memiliki efek perlindungan terhadap kerusakan jaringan dari radikal bebas, secara hipotetis dengan sekresi berbagai faktor pertumbuhan yang mempercepat penyembuhan luka. Penelitian ini bertujuan untuk mempelajari pengaruh NAC terhadap tingkat faktor pertumbuhan endotermal vaskular (VEGF) dan faktor pertumbuhan fibroblast (FGF) dalam model luka bakar listrik tikus. Metode: Penelitian ini menggunakan desain randomized post-test only control group. Dalam penelitian ini, terdapat empat puluh dua tikus jantan galur Wistar yang ditempatkan dalam enam kelompok. Setiap tikus menerima arus bolak listrik sebesar 220 volt dengan intensitas 450-500 mA pada satu ekstremitas. Pengambilan sampel arteri femoralis dilakukan setelah pemberian dosis pertama NAC, setelah dosis pada hari ketiga, dan setelah delapan hari dari masing-masing dosis. Seluruh spesimen arteri femoralis dikenai pewarnaan dengan metode imunohistokimia dan diperiksa di bawah mikroskop dengan pembesaran 300 kali untuk mengevaluasi ekspresi VEGF dan FGF. Data dari seluruh sampel dikumpulkan dan kemudian dianalisis secara statistik. Hasil: Kadar rata-rata VEGF kelompok tikus yang menerima NAC lebih tinggi daripada kelompok kontrol dari awal pengamatan sampai hari ke 8. Hasil FGF pada tikus kontrol lebih tinggi pada hari ke-0 dan hari ke-8 dibandingkan dengan kelompok tikus yang menerima NAC. Namun, dalam tes yang berbeda tidak ada perbedaan yang signifikan (p>0,05) yang ditemukan pada pengukuran VEGF dan FGF pada hari yang sama antara kelompok kontrol dan kelompok perlakuan. Kesimpulan: Tidak ada perbedaan yang signifikan pada VEGF dan FGF antara kelompok kontrol negatif dan kelompok yang menjalani perlakuan.

CORELATION OF PARENTS' PROFILES OF CHILDREN WITH LATE CLEFT REPAIR IN SURABAYA CLEFT LIP AND PALATE CENTRE (JANUARY 2015–DECEMBER 2017) Ningrum, Laras Puspita; Saputro, Iswinarno Doso; Zarasade, Lobredia
Jurnal Rekonstruksi dan Estetik Vol. 5 No. 1 (2020): Jurnal Rekonstruksi dan Estetik, June 2020
Publisher : Universitas Airlangga

Highlights: Economic factors and insufficient information about cleft palate treatment was the primary cause of delayed repairs,except for Parents' education levels. The essential responsibility of primary care physicians is to provide education on treatment stages to minimize delays. Abstract: Introduction: Optimal time of Cleft palate repair is during the 10 to 12 month of age. In this time produce far natural results in terms of speech because it enabled the maturation of scar tissue postoperatively. The soft palate must function properly before the patient starts learning to talk, otherwise speech disorders such as persistent rhinolalia aperta might arise. In pediatric patients, the role of parents is very important on adherence to therapy. Methods: This is a cross-sectional study. The first study group was parents of patients who had surgical repair before two years old and the second group was the parents of patients who had repair after two years old. We compared age, monthly income, education level, number of children, and residential distance from Surabaya of the two groups. Results: The data of this study were obtained from the medical records of patients with cleft lip surgery at CLP Center Surabaya in 2015th-2017th with total of 358 patients, 172 were female and 186 were male. 52 patients with delayed cleft palate surgery. Patients' parents in both groups were mostly 31- 40 years old, were high school graduated, has one child, earned less than 1.5 million rupiah a month, and lived less than 100 kms from Surabaya. From the statistical results, parent's income has the strongest correlation with the patient's age in cleft palate surgery (-2.7). A negative coefficient means that the less parent's income, the more patient likely had delayed cleft palate surgery. While other factors found weak and very weak correlations. Conclusions:The results form patient's parents' interview, concluded that besides economic factors, the lack of information cleft palate treatment is the key factors that contributed to the delay of cleft palate repair. The education level does not affect the delay in cleft palate surgery, because even in high educated parents, sometimes they don't understand the stages of cleft lip and palate treatment. This study emphasized the necessity to educate about the stages of surgery by primary care physicians, to minimize delays.

MANDIBULR CONDYLE FRACTURE MANAGEMENT OUTCOME IN DEPARTMENT OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY, DR. SOETOMO GENERAL ACADEMIC HOSPITAL (2015-2018) Zarasade, Lobredia; Saputro, Iswinarno Doso; Putri, Nadia Tamara
Jurnal Rekonstruksi dan Estetik Vol. 5 No. 1 (2020): Jurnal Rekonstruksi dan Estetik, June 2020
Publisher : Universitas Airlangga

Highlights: The management of mandibular condyle fractures is determined based on patient age, fracture type, systemic health, other maxillofacial fractures, and dental conditions factors. Out of the total patients indicating successful management of mandibular condyle fractures at Dr. Soetomo Hospital. Abstract: Introduction: The high incidence of condyle mandible fractures is due to the role of the mandibular ramus which has stronger resistance compared to head condyle mandibular. The management of condyle fractures is still controversial because of the prognosis. Management of condyle fractures of the mandible should aim at maximally reducing morbidity, postoperative complications, and aesthetic and/ or functional impairment. Methods: The medical records of 56 patients with condyle mandible fractures who presented at the Dr. Soetomo General Academic Hospital Surabaya from January 2015 to December 2018 were reviewed retrospectively. We analyzed characteristics of the patients (age), type of fractures, management of fractures, and outcome from management. Results: This study shows that a total of 56 patients, 22 were patients with mandibular condyle fractures only and 34 patients with mandibular condyle fractures with other maxillofacial fractures. The studied showed that male patients (84%) is more than female patients (16%). The mean age of the patients involved in this study was 28.25 ± 1.78 years, with the youngest being 12 years old and the oldest being 67 years old. The results of the overall study with good occlusion results in 48 patients, it was found that 22 patients were treated with closed reduction and 26 patients with open reduction were performed. Conclusions: The results of condyle mandibula fracture management in Dr. Soetomo Hospital has been according to the indication with the treatment indication along with the result of good management.

PALATAL FRACTURE FIXATION ON SEVERE PANFACIAL FRACTURE: IS THERE ANY CLINICAL SIGNIFICANCE? Prasetyo, Arif Tri; Hutagalung, Magda Rosalina; Zarasade, Lobredia
Jurnal Rekonstruksi dan Estetik Vol. 3 No. 1 (2018): Jurnal Rekonstruksi dan Estetik, June 2018
Publisher : Universitas Airlangga

Highlights: A panfacial fracture patient received effective surgical treatment, with a primary focus on aligning the upper jaw arch by addressing the hard palate through various surgical methods. Palate fractures, while relatively rare, require plate stabilization and can lead to challenges such as teeth misalignment and wound issues. Abstract: Introduction: Fractures of the hard palate are infrequent. They are found in less then 10% of patients with midfacial fractures. They practically never occur in isolation and are usually part of alveolar process fractures or more complex midfacial fractures of the Le Fort type. Treatment of palatal fractures is planned and performed with the goal of restoring the transverse width of the palate, the anteroposterior projection of the maxillary arch, and the patient's pretraumatic occlusal plane, as well as maintaining horizontal stability of the midface. Case Illustration: Reporting patient female 17 years old with panfacial fracture due to traffic accident. There was slight epidural haemorrhage on frontal area. The fractures are on upper face, midface, and lower face including the hard palate. We performed open reduction internal fixation on palate to correct the arch of the upper jaw. The other fracture site can be corrected easier. The approaches that we done are bicoronal, subsilier, and intraoral. Discussion: In a case of severe panfacial fracture with upper jaw misalignment and an existing laceration, we opted to use miniplates for palatal fixation without making new incisions. Palate fractures are relatively uncommon and are associated with significant rates of malocclusion and wound complications. These injuries are typically managed with plate fixation of the alveolar ridge with variable approaches to the palatal vault. Conclusion: The patient was successfully treated using bottom-up and outside-in sequence by accessing all facial injuries. Postoperatively, radiograph examination revealed good reduction and fixation of titanium plates, and physical examination revealed good functional and aesthetic outcomes. However, it's important to note that there's a risk of osteosynthesis material exposure in the future.

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