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TREATMENT OF PRESSURE ULCERS OF THE SCALP IN DECOMPENSATED HYDROCEPHALY: A CLINICAL CHALLENGE. Kale, Letitia Bellavesta; Malelak, Elric Brahm; Datusanantyo, Robertus Arian; Ullah, Wajahat; Ali, Ahmed Mohamed Ahmed; Thumar, Dhyey; Kumar, Kundan
Jurnal Rekonstruksi dan Estetik Vol. 8 No. 2 (2023): Jurnal Rekonstruksi dan Estetik, December 2023
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jre.v8i2.49972

Abstract

Highlights: Studies of pressure injury in hydrocephalus patients are very limited. To determine the staging and diagnosis, clinicians must consider the anatomical location of pressure injury, especially in children. Pressure injury increases the risk of shunt infection in hydrocephalus patients. Abstract: Introduction:  A pressure injury is ‘localized injury to the skin and/or underlying tissue usually over a bony prominence, that caused by compression. Multiple studies have demonstrated that age, moisture, immobility, and friction/shear are key risk factors. We report a challenging case of multiple pressure injury over the scalp in hydrocephalus patients. Case Illustration: Three toddlers with Hydrocephalus was consulted due to multiple Pressure Injury over the scalp in the bilateral temporo-parietal and occipital region. After ventriculo-peritoneal shunting (VP-shunt), the wounds were managed in accordance with TIMERS guidelines. Discussion: Pediatric tissues are more susceptible to deformation injuries. Severe skull deformity and macrocephaly are serious problems that may lead to difficulties in head control and child positioning increases the risk of pressure injury. After VP-shunt, wound care is even more challenging since the surgical wound is closely related to pressure injuries. Shunt exposure can be occurred on these patients. According to both examination and intervention of TIMERS guidelines are essential as well as controlling risk factors of pressure injury development.     Conclusion: Surgeons should be aware that children with hydrocephalus may experience scalp injuries and changes to their body composition, which challenge the diagnosis and care process.
Issues and Challenges in Implementing Braden Scale to Assess Pressure Injury Risk: A Participatory Action Research in South-Eastern Indonesia Buntoro, Ika Febianti; Datusanantyo, Robertus Arian; Koamesah, Sangguana M. J.; Wijaya, R. Pasifikus Christa; Handoyo, Nicholas Edwin
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.v12i1.386

Abstract

Background: Pressure injury (PI) is chronic wound over bony prominence that should be managed to avoid morbidity and increased costs. Braden scale (BS) has been used worldwide for almost forty years as PI's standard risk assessment tool. This study aimed to identify issues among nurses regarding the implementation of the PI risk assessment tool in a referral hospital in rural Indonesia.Methods: We performed two cycles of participatory action research (PAR) to initiate the BS implementation and to establish follow-ups accordingly in inpatient units. The PAR ensured the active roles of the 12 nurses and midwives who initially implemented the tool. The transcribed focused-group discussion (FGD) recordings were analysed following six steps of thematic analysis.Results: There were three main themes emerged. The themes were the nurses' understanding of the need for PI risk assessment, the increasing workload when implementing PI risk assessment, and the importance of the primary nurse role. The themes reflects the need for nurse practitioners to further implement the tool by seeking confirmation from the primary nurse's group. The ease and trialability of the BS enhanced the nurses' compliance with the new tool. The nurse manager and leader needed to concentrate on perceived innovation attributes to implement the PI risk assessment tool further.Conclusion: The PAR cycles have recruited early adopters and suggested implementing BS to assess PI risk. The role of hospital managers and leaders in ensuring continuity of implementation is crucial.
ONE-STAGE MODIFIED BIPEDICLED SCROTAL FLAP IN PENILE SCLEROSING LIPOGRANULOMA SURGICAL RECONSTRUCTION: A CASE SERIES Telussa, Arley Sadra; Datusanantyo, Robertus Arian; Kale, Letitia Bellavesta; Djunaedi, Angela
Indonesian Journal of Urology Vol 33 No 2 (2026)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v33i2.968

Abstract

Introduction: Sclerosing lipogranuloma is commonly encountered by urologists and plastic surgeons. Despite potential permanent damage, increasing penile size by injecting unusual substances, usually oil-based, becomes a trend in society. The immediate result, practicality, and affordability of the procedure caused penile shaft deformity, pain, and difficulties in sexual activity. Objective: This study aims to report three cases of modified scrotal flap reconstruction techniques to reconstruct heavily deformed penile shafts with satisfying results. Case(s) Presentation: Three males presented with painful enlarged and deformed penile shaft following a penile enlargement procedure by injection of unusual substances done by non-medical practitioners. Following penile sclerosing lipogranuloma diagnosis, lipogranuloma excision and one-stage modified bipedicle scrotal flap were conducted for all patients. Discussion: A reconstructive procedure is needed to eliminate pain and restore sexual functions. Among available surgical reconstruction techniques, the bipedicled scrotal flap was more suitable in most limited healthcare setting for its less technical complexity, fewer complications, better aesthetic outcomes, and better sexual functions. All cases were reconstructed in a one-stage procedure, they were cost-efficient without losing their features. Conclusion: The one-stage modified bipedicled scrotal flap technique is a beneficial technique for penile reconstruction caused by sclerosing lipogranuloma, especially in health centers where patients reside in distant places. Keywords: Sclerosing lipogranuloma, scrotal flap, reconstruction techniques.