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Amniotic Band Sequence, Frequently Misdiagnosed in Cleft Patients Putri, Nandita Melati; Handayani, Siti; Bangun, Kristaninta
Jurnal Plastik Rekonstruksi Vol. 1 No. 3 (2012): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Amniotic band sequence (ABS) is a set of congenital malformations attributed to amniotic bands that entangle fetal parts during intrauterine life. thiopatogenesis of this sequence is still unknown. Because of such a wide spectrum of possible anomalies and many combinations of their simultaneous appearance, there are no two identical cases of ABS. This diagnosis is often missed based on the secondary major defects.Patients and Methods : There are cases of cleft patients treated in Plastic Surgery Division Cipto Mangunkusumo Hospital that has other congenital anomalies. The data is taken from the medical record and surgical photos (in our division from 2010-2011). Results : The patients presented had either facial cleft or cleft lip and palate. These patients had other congenital anomalies such as meningoencephalocele and constriction ring syndrome or other defects on the extremities.Summary : This diagnosis may not be often established because we often only see the secondary major defects such as meningoencephalocele or facial cleft. With this paper we hope that we could make this diagnosis known so we can make a multidisciplinary approach to this sequence.

The Advantages of Vascularized Fibular Bone Graft For Mandibular Tumor Reconstruction Atmodiwirjo, Parintosa; Putri, Nandita Melati
Jurnal Plastik Rekonstruksi Vol. 1 No. 1 (2012): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Mandibular reconstruction are often indicated in patient who underwent ablation or excision of the mandible due to malignancy of the oral cavity.In this paper we will discuss about the mandibular reconstruction with use of alloplastic implant, and vascularized bone graft. Four cases of oral cavity tumor which were referred to the plastic surgery division at Cipto Mangunkusumo hospital during 2005-2011, after being diagnosed with oral cavity tumor were re-viewed. Mandibular reconstruction can be done using alloplastic implant, non-vascularized bone graft or vascularized bone graft. In this paper we studied four patients who needed mandibular reconstruction after ablation of oral cavity tumors. Patients who underwent reconstruction with alloplastic implants all had complications such as broken hardware. Where as in patient who underwent free fibular tissue transfer there were no complications at all. We can conclude that in less vascularized surrounding tissue as in cases that received or will receive other treatment such as chemotherapy or radiation that vascularized bone graft are superior. The bone healing in vascularized bone graft also does not depend on creeping substitution like in non vascularized bone graft.

Parental Age As a Risk Factor Of Children With Cleft Lip In Jakarta Population: Does Paternal Age Play A Role? Widayanti, Nurina; Sudjatmiko, Gentur; Putri, Nandita Melati
Jurnal Plastik Rekonstruksi Vol. 4 No. 1 (2017): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Cleft lip and palate (CL/P) is one of the most common congenital anomalies with the prevalence of 1 case for every 1000 birth. The purpose of this study is to evaluate the association between paternal and maternal age to the incidence of cleft lip with or without cleft palate. Methods: This case-control study compares data of 74 cleft lip patients who was enrolled in Gentur Cleft Foundation Foundation year 2013 to 2015 compared to those of 86 normal children. Paternal and maternal age were categorized and compared to reference age (25-29 years old). Binary logistic regression was used to assess the interaction between paternal and maternal age adjusted to several confounding factors. Results: Paternal age (PA) 18-24 year has OR 9.12 (95% CI = 2.2-36.7), PA 30-34 has OR 2.74 (95% CI =1.2-5.9), PA 35-48 has OR 5.82 (95% CI = 2.2-15.67) compared to those in the 25-29 years category. Maternal age (MA) 18-24 year has OR 4.385 (95% CI = 1.86-10.36), MA 35-48 has OR 6.58 (95% CI = 1.65-26.31) compared to those in the 25-29 years category. P-value was insignificant for MA 30-34 years. Interaction were observed in crossings between PA 18-24 with MA 18-24, PA 25-29 with MA 18-24, PA 30-34 with MA 18-24, PA 30-34 with MA 25-29, PA 35-48 with MA 30-34, and PA 35-48 with MA 35-40. Conclusion: We observed stronger association between paternal ages with CL/P compared to that of maternal age. Interactions of paternal and maternal age with high OR were found in youngest age group (18-24 years old), oldest age group (above 35 years old), and fathers who are approximately 10 years older than the mother.

Granulation Red Index To Assess Pressure Ulcer Granulation Tissue Quality Treated By Honey Gauze Dressing By Digital Image Analysis Fortuna, Fory; Putri, Nandita Melati; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 6 No. 2 (2019): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background : Good formation of granulation tissue in the ulcer bed is regarded as one of the indicators of pressure ulcer healing. Granulation red index (GRI) had been published as an objective parameter to assess the quality of granulation tissue. Honey stimulates granulation of tissue and creates a moist healing environment. However, the assessment of granulation tissue quality of pressure ulcers treated by honey has yet to be proven in clinical settings. In this study, we evaluate the granulation tissue quality of pressure ulcers treated by honey using granulation red index by digital image analyses. Method: There were 12 subjects who fulfill inclusion criteria treated by honey gauze dressing and were evaluated every week for three times measurements of %GRI and DESIGN-?score. Parameters of this study were the delta %GRI80 and DESIGN-?R score. Correlations were evaluated by Spearman’s correlation coefficient. Result : The correlation of delta GRI80% and DESIGN-?R score was statistically significant from baseline measurement to first week of treatment and to second week of treatment (r1=0.65, p1=0.02 and r3=0.832, p2=0.001). The correlation of delta GRI80% and DESIGN-?R score from first to second week therapy was not statistically significant (r=0.23, p=0.47), but the GRI80% from first week therapy to second week of therapy was increasing and DESIGN R score was decreasing. Conclusion:This study shows the correlation of %GRI80 and DESIGN-?R score of pressure ulcer after the treatment of honey gauze dressing. This study hopefully assists further study for wound bed preparation assessment and treatment of pressure ulcer for surgical intervention.

Keystone Flap for Reconstruction of Sacral and Ischial Pressure Injury Tunjung, Narottama; Putri, Nandita Melati
Jurnal Plastik Rekonstruksi Vol. 8 No. 1 (2021): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jprjournal.v8i1.319

Introduction: Reconstruction of sacral and ischial pressure injury offers great challenges due to its high complication and recurrence rate. Providing durable tissue coverage with minimal donor site morbidity is paramount while ensuring fast operative time for the patients who often possess multiple comorbidities. This study aims to present cases of sacral and ischial pressure injury reconstruction using a keystone flap. Method: A retrospective study was performed by reviewing data from fifteen patients with a sacral and ischial pressure injury who underwent reconstruction using various types of keystone flaps in our center between 2019 and 2020. Results: The patients’ age ranged from 10 to 83 years old (average, 40.5 years old). The average wound dimensions were 9.4 ± 3.1 cm x 6.5 ± 2.7 cm and the mean area of the defects was 52.3 ± 35.7 cm2, with the largest defect was 15 x 12 cm (141.3 cm2). Mean operative time was 140 ± 24.5 minutes with nine wounds were reconstructed using type IV keystone flap (60%) and six patients using type IIA (40%). Postoperative complications occurred in three patients (20%). Other patients resulted in uneventful complete healing. Conclusion: The keystone flap is reliable, simple, has a fast technique, and minimal donor site morbidity to cover the defects of sacral and ischial pressure injury. Performing thorough debridement, choosing the right type of keystone flap, elevating the flap adequately to allow mobilization, preserving perforator “hotspots”, and suturing of the flap without tension are keys to achieve satisfactory results.

Comparison Study of Bacterial Profile, Wound Healing, and Cost Effectiveness in Pressure Injury Patients Using Treatment Honey Dressing and Hydrogel Putri, Nandita Melati; Margareta Lumbuun, Ruth Fitri; Kreshanti, Prasetyanugraheni; Saharman, Yulia Rosa; Tunjung, Narottama
Jurnal Plastik Rekonstruksi Vol. 9 No. 1 (2022): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jprjournal.v9i1.334

Background : Pressure injury is a localized soft tissue injury caused by prolonged pressure over bony prominence. Most published papers used Manuka honey as dressing, while this product is expensive. As this reason, this study will use local product honey called Nusantara honey, to prove the use of local honey has better healing process, bacterial profile, and cost effectiveness, compared to the standard dressing, hydrogel.Method : This is a one-month experimental study conducted in patients with pressure injury that referred to our division. Parameter of the bacterial profile was taken from deep-tissue specimen. The healing process was examined with Pressure Ulcer Scale for Healing (PUSH) Tool. Cost was accumulated after all the treatment. Data was analysed with t-Test or Mann Whitney (if the distribution is not normal), with statistical significance was define as p<0.05..Result : Of 26 wounds, 12 were randomized to hydrogel and 14 to honey dressing. Characteristics were determined by sex, age, body mass index, level of consciousness, mobilization status, immobilization etiology, comorbidities, grade and location of ulcer, hemoglobin, leukocytes, and albumin level. There was clinically significant wound size reduction in honey dressing according to PUSH Tool (p=0.118). The bacterial profile and reduction were similar. Honey dressing appeared to be more cost effective in terms of dressing cost (p<0.001) and lower total cost.Conclusion: The local honey dressing has better wound healing outcome, although it is not statistically significant. Its capability of decreasing pathogens is similar with hydrogel, with lower cost, particularly the dressing cost. This local honey dressing could be a good choice as wound dressing in areas where the modern dressings are not available.

Increased Nutrition Intake from Day 1 to Day 7 and Its Correlation with LOS in The Burn Unit of Dr. Cipto Mangunkusumo Hospital Jakarta Sinaga, Wina; Nurul Ratna Mutu Manikam; Aditya Wardhana; Nandita Melati Putri; Lily Indriani Octovia; Akhmad Noviandi Syarif
Jurnal Plastik Rekonstruksi Vol. 9 No. 2 (2022): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jprjournal.v9i2.339

Introduction : Burn patients as well as the critically ill experience strong oxidative stress, an intense inflammatory response, and a prolonged months-long hypermetabolic and catabolic response that affect nutritional requirements. This study aimed to investigate the nutrition intake in the acute phase from day 1 to day 7 and the correlation with length of stay (LOS) in burn patients in Dr. Cipto Mangunkusumo General Hospital.Method : This cross-sectional study was conducted from January to December 2020 in the Burn Unit of Dr. Cipto Mangunkusumo General Hospital. Research subjects were burns patients who were willing to take part in this research and met the research criteria. The characteristics data included gender, age, burn area, cause of burns, body mass index, and intake analysis were obtained from medical records and were analyzed using Spearman’s correlation and linear regression.Result : A total of 68 subjects were included in this study. There was an increase in energy intake from day 1 to day 7 of 10.81 + 12.73 Kcal/kgBW. There was a significant negative weak correlation between energy changes from day-1 to day-7 and length of stay (r = -0.25, p = 0.03).Conclusion: The higher energy increases within 7 days of treatment, the shorter the LOS of burn patients. Further research is still needed to assess the components that influence nutrition intake and how they impact the clinical outcome of burn patients.

Analyzing The Efficacy and Outcome of Amniotic Membrane in Burn Care: A Systematic Review and Meta-Analysis Putri, Nandita Melati; Wardhana, Aditya; Sandora, Normalina; Syarif, Akhmad Noviandi; Farhana, Nadya; Oklia, Sheila
Jurnal Plastik Rekonstruksi Vol. 12 No. 1 (2025): (2025): Jurnal Plastik Rekonstruksi
Publisher : The Lingkar Studi Bedah Plastik Foundation and is affiliated with the Department of Plastic Surgery, Faculty of Medicine, Universitas Indonesia.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jprjournal.v12i1.384

Introduction: Managing burn injuries is a significant clinical challenge in promoting wound healing and minimizing complications. Advances like amniotic membrane as a biological dressing have been introduced to improve wound healing. This study analyzes the efficacy of amniotic membrane in burn care and its impact on wound healing outcomes.Methods: We conducted a systematic review in Pubmed, Cochrane, and ScienceDirect, using “Amnion”, “Burns”, and “Wound healing” as keywords. The inclusion criteria are studies assessing the application of amniotic membrane on burn wounds. The outcome measures were mean healing time, wound healing rate, incidence of wound infection, dressing renewal frequency, pain score, and LOS.Results: We identified eleven trials (n=971) ranging from the year 1989 to 2023, containing eight RCTs, and three NRCTs. The pooled RR showed statistically significant differences between amniotic membrane group and control group in mean healing time (RR -4.52 [95% CI; -6.93, -2.11]; p=0.0002), wound healing rate (RR 1.60 [95% CI; 1.09, 2.33]; p=0.02), incidence of wound infection (RR 0.48 [95% CI; 0.30, 0.77]; p=0.002), and dressing renewal frequency (RR -1.64 [95% CI; -2.48, -0.79]; p=0.0002).Conclusion: This meta-analysis indicates that amniotic membrane is advantageous as a biological dressing for burn patients.

The Outcome of Keystone Flap for Lower Extremity Defects: A Systematic Review Marcevianto, Kevin Varian; Wardhana, Aditya; Putri, Nandita Melati
Jurnal Plastik Rekonstruksi Vol. 11 No. 2 (2024): (2024) Jurnal Plastik Rekonstruksi
Publisher : The Lingkar Studi Bedah Plastik Foundation and is affiliated with the Department of Plastic Surgery, Faculty of Medicine, Universitas Indonesia.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jprjournal.v11i2.373

Introduction : Lower extremity defect poses a significant challenge in reconstructive surgery due to the limited usability of soft tissue. The keystone flap which utilizes fasciocutaneous perforators, has emerged to be a potential technique in fixing soft tissue defects. However, scientific evidence, specifically on its effectivity and complication rate in lower extremity defect is lacking. Therefore, this systematic review aims to assess the outcome and potential complications correlated to the use of Keystone Flap in repairing lower extremity defect. Method : This systematic review was done in accordance to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Literature searching was conducted using four databases, which is PubMed Central, Embase, Scopus and Cochrane Library. Result : A grand total of sixteen studies were included in the review. Among it, fourteen studies were case series. The others were cohort prospective and single arm interventional studies. Out of the 662 keystone flaps used, a total of 129 complications (19.5%,) were recorded, with the majority being infection or cellulitis (5%, n=33), delayed healing (4.5%, n=30), wound dehiscence (4.3%, n=28), and partial flap loss or necrosis (2%, n=13). Conclusion: The keystone flap could be an alternative for lower extremity defect with a realtively low complication rate.

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