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All Journal The Indonesian Biomedical Journal Acta Biochimica Indonesiana Jurnal Plastik Rekonstruksi The New Ropanasuri Journal of Surgery Jurnal Rekonstruksi dan Estetik
Yefta Moenadjat
Department Of Surgery, Faculty Of Medicine, Universitas Indonesia, Jakarta
Biochemistry, Genetics & Molecular Biology Civil Engineering, Building, Construction & Architecture Health Professions Immunology & microbiology Medicine & Pharmacology Public Health Other

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Effectiveness of Debulking Liposuction in Secondary Inferior Extremity Fat–Predominant Lymphedema: Evaluation of the of Leg Dermal Backflow Improvement Using Indocyanine Green Lymphography Puspasari, Antonia Valentine; Atmodiwirjo, Parintosa; Moenadjat, Yefta; Ramadan, Mohamad Rachadian
Jurnal Plastik Rekonstruksi Vol. 12 No. 2 (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.v12i2.30

Abstract

Background:Secondary lymphedema with a predominant composition of fat is not effectively managed with physiological techniques. Instead, it necessitates debulking liposuction that reduces extremity circumference and improves lymph flow. This study aims to discover the effectiveness of improving lymphatic flow through indocyanine green lymphography examination.Methods: This retrospective cohort study involving secondary fat–predominant lower extremity lymphedema patients who underwent debulking liposuction in the Division of Reconstructive Plastic and Aesthetic Surgery, Department of Surgery, CMGH, in December 2022 - August 2024. The variables studied were the subject's lower extremity circumference and degree of leg dermal backflow before and after debulking liposuction.Results: Among 15 subjects, pre- and postoperative debulking liposuction measurements of inferior extremity circumference demonstrated significant reduction at 10 cm and 25 cm above the ankle, the patella, 10 cm and 25 cm above the knee. Postoperatively, 5 subjects with leg dermal backflow stage IV turned to stage II (1), III (4), while 10 subjects with the leg dermal backflow stage V turned to stage IV (9).Discussion: Reduction in the circumference of the inferior extremities after debulking liposuction at almost all measurement points except for the foot and ankle circumference. This related to the anatomy of lymphatic flow. Debulking liposuction showing a significant improvement in lymphatic flow, it clinically proven by the reduction dermal leg backflow degree after procedure.Conclusion: Debulking liposuction in secondary lower extremity lymphedema with a predominant composition of fat effectively reduces extremity circumference and improves lymphatic flow as evidenced by indocyanine green lymphographic examination.
Methylene Blue as an Adjuvant Analgesic Postoperative Anal Fistula: A Randomized Clinical Trial Jeo, Wifanto S.; Irsal, Muhammad FA; Tamba, Riana P; Moenadjat, Yefta; Friska, Dewi
The New Ropanasuri Journal of Surgery Vol. 9, No. 1
Publisher : UI Scholars Hub

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Introduction. Anal fistula is a pathological condition that connects the anorectal mucosa to the perianal skin, requiring various types of surgical procedures. However, surgery often causes postoperative pain. The use of methylene blue is being studied as a potential analgetic adjuvant in anal fistula surgery. Previous studies have shown that methylene blue can effectively reduce postoperative pain in various types of anorectal surgery. This study aims to determine methylene blue's clinical efficacy as an analgetic adjuvant. Methods. A double-blind, randomized controlled trial was conducted. Subjects consisting of subjects with simple anal fistula to undergo fistulectomy were randomly allocated into two groups. The first group received adjuvant analgesics in the form of methylene blue and NSAIDs, while the second group only received NSAIDs. Methylene blue 4 mL 1% was administered subcutaneously to the edge of the wound, sprayed on the surgery site, and intravenously administered ketorolac 3 x 30 mg. Randomization was done using the double-blind method. Pain levels were evaluated on the first, second, third, and seventh postoperative days using a visual analog scale (VAS). Results. Thirty-four subjects were enrolled (17 subjects in each group). Significant differences in pain levels (VAS values) were recorded between the group receiving the combination of methylene blue and NSAIDs compared to the group receiving only NSAIDs on days 1 to 3 after surgery (p <0.05). This difference was no longer significant between the two groups on the seventh postoperative day (p >0.05). Conclusion. The use of methylene blue in subjects undergoing anal fistula surgery as an adjuvant analgesic along with NSAIDs may reduce the intensity of pain better than NSAIDs alone.
Evaluation of antimicrobial stewardship implementation in elective surgery in dr Cipto Mangunkusumo General Hospital using Gyssens Method Ulima, Rhea P; Moenadjat, Yefta
The New Ropanasuri Journal of Surgery Vol. 9, No. 1
Publisher : UI Scholars Hub

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Abstract

Introduction. Nowadays, surgical site infections (SSI) remain the most common complication of surgical procedures. In prevention, prophylactic antibiotics are the first option, which leads to the high use of antibiotics. However, antibiotic administration should be based on strategies such as stewardship. Thus, the study aimed to assess the situation using Gyssens' method. Method. A retrospective cohort study analyzed the antibiotic administration of most major elective surgeries, including thyroidectomy, mastectomy, and cholecystectomy, proceeded in Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia, from January to July 2023. Indication, type, dosage, timing, interval, duration, and route of administration were the variables of interest. Results. Of 191 subjects who underwent the most common elective surgery procedures, 30 used combination antibiotics. Gyssens category 0 consists of 165 subjects (86.5%), and 11 subjects (5.8%) were classified as category IIA, indicating inappropriate dose (inadequate, insufficient). Inaccuracies were identified as mistimed administration (5.8%), less effective antibiotic selection (3.1%), incorrect dosage (2.6%), and inappropriate timing (2.1%). The association of Gyssens categories with SSIs showed a p-value of > 0.05 with an odds ratio of 1, indicating that both appropriate and inappropriate antibiotics of the Gyssens category showed no impact on SSIs or non–SSIs. Conclusion. The adherence to antimicrobial stewardship in the most common elective surgery in the Department of Surgery, dr. Cipto Mangunkusumo General Hospital was 86.4 and subjected to improvement.
Transformation of accreditation of higher education in health in Indonesia: qualitative assessment Moenadjat, Yefta; Tunru, Insan Sosiawan A.; Soemardjo, Sutrisno
The New Ropanasuri Journal of Surgery Vol. 9, No. 2
Publisher : UI Scholars Hub

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Abstract

Accreditation of higher education in health in Indonesia shifts to the qualitative assessment driven to ensure quality improvement. The method replaces the former quantitative assessment method that has been applied since 2012; it will be effective in January 2025. The driving factors and rationale of transformation are outlined in this article. The rationale of the qualitative assessment that applies principle–based accreditation and the quantitative assessment that applies rule–based accreditation is reviewed here. Information on the accreditation procedure and the goal is presented, aiming for institutions to prepare for this new version of accreditation.
Co-Authors Abdul Halim Sadikin Agus Firmansyah Ahmad Aulia Jusuf Anis Karuniawati Aria Kekalih Atmodiwirjo, Parintosa Benjamin Ngatio, Benjamin Camy F. Surjadi Caroline T. Sardjono Dalima A.W. Astrawinata Damayanti Sekarsari Dewi Friska Ferry Sandra Handaya, Adeodatus Y. Hasibuan, Muhamad Irfan A Indah S. Widyahening Irsal, Muhammad FA Iskandar Rahardjo Budianto Ismet, Mohamad F. Iswanto, J. Jeanne A. Pawitan Jeo, Wifanto S. Jeo, Wifanto Saditya Kusnadi, Dana S. Lia Damayanti Marini Stephanie Maulanisa, Sinta C. Maurin Merlina Mazni, Yarman Mohamad Rachadian Ramadan Mohamad Sadikin Mulya, Dina Mulya, Dina D. Nasution, Safruddin Novi Sylvia Hardiany Nurjati C. Siregar Pratama, Dennis W. Puspasari, Antonia Valentine Putranto, Agi S Putranto, Agi S. Radiana D. Antarianto Ramdhani, Aris Retno Asti Werdhani Rianto Setiabudy Robby, Rizky DK. Saukani Gumay Saunar, Rofi Y. Saunar, Rofy S. Septelia I. Wanandi Soemardjo, Sutrisno Suharto, Wuryantoro Syafina, Adinda B Tamba, Riana P Toar J.M. Lalisang Tony Loho Tunru, Insan Sosiawan A. Twidy Tarcisia, Twidy Ulima, Rhea P Usman, Nurhayat Vanto, Yoni Vivian Soetikno Yuyus Kusnadi