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All Journal Jurnal Plastik Rekonstruksi Indian Journal of Forensic Medicine & Toxicology Jurnal Rekonstruksi dan Estetik

Nata’atmadja, Beta Subakti

Department Of Plastic Reconstructive And Aesthetic Surgery, Faculty Of Medicine Universitas Airlangga

Author-ID : 4224562

Civil Engineering, Building, Construction & Architecture Medicine & Pharmacology Public Health Other

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CLINICAL PROFILES OF FROSTBITE IN DR. SOETOMO GENERAL ACADEMIC HOSPITAL: A CASE SERIES Wahyu Nugroho, Thomas Eduardus Sudrajat; Beta Subakti Nata’atmadja
Jurnal Rekonstruksi dan Estetik Vol. 4 No. 1 (2019): Jurnal Rekonstruksi dan Estetik, June 2019
Publisher : Universitas Airlangga

Highlights: This study presents three cases of frostbite in adults who participated in a Mount Denali expedition, highlighting the treatment process and outcomes. The importance of long-term follow-up management and prioritizing finger preservation and potential reconstruction in patient care. Abstract: Introduction: Frostbite is a common cold-related injury, especially among mountaineers in high-altitude settings. These injuries can occur both in freezing and above-freezing temperatures. The main goal of this study is to understand the clinical aspects of frostbite cases treated at Dr. Soetomo General Academic Hospital in Surabaya. Case Illustration: We present three cases of frostbite in adults who were part of a Mount Denali expedition, reaching an altitude of 6192 meters. Initial treatment included rewarming and pain relief. They were admitted to our facility 11st days after the injury, with one patient undergoing finger amputation on the 71st day. All received standard antibiotics and three days of hospital care. No initial surgeries were performed; instead, wound checks and rehabilitation were done as outpatients. On the 71st day, one patient had the third and fourth fingers amputated. The study found changes in platelet counts during the acute frostbite phase but no significant changes during the subacute phase following cold exposure. Discussion: The cases showed substantial improvements in wound healing, reduced swelling, increased mobility, and overall better health. Clear demarcation of damaged tissue occurred during observation. While frostbite is rare in tropical areas, it can impact individuals in cold-weather activities like mountain climbing and winter sports. Effective prevention and management are vital for good outcomes. Initially, conservative treatment is suggested, but surgery may be needed when the extent of tissue damage is apparent. Conclusions: Long-term follow-up management is necessary to achieve a good functional outcome. Preservation and if necessary reconstruction of the finger should become a priority in the patient management.

DEVIATION AND ATROPHY OF MIDDLE PHALANX OF HAND FOLLOWING PARTIAL SEPARATION IN SYNDACTYLY PATIENT: THEIR FAULT OR OURS? Kusuma, Diana Murtiati; Saputro, Iswinarno Doso; Rizaliyana, Sitti; Beta Subakti Nata’atmadja
Jurnal Rekonstruksi dan Estetik Vol. 3 No. 1 (2018): Jurnal Rekonstruksi dan Estetik, June 2018
Publisher : Universitas Airlangga

Highlights: Complex syndactyly reconstruction presents surgical challenges, often resulting in rotational, angular, and nail deformities post-surgery. The early correction of congenital syndactyly, combined with dorsal rectangular flap usage and full-thickness skin grafts, leads to satisfactory outcomes and reduces the need for multiple surgeries per web Abstract: Introduction: Syndactyly is failure of differentiation in which the fingers fail to separate into individual appendages. It is the most common congenital hand anomaly, with an incidence of 1 in 2,000 to 2,500 live births. Surgical separation of fingers as early as 6 month-old is indicated when syndactyly involves digits of unequal length (i.e., ring and little fingers). Early separation is also required in complex syndactyly and cases of acrosyndactyly. The timing of surgery of all other cases of syndactyly remains somewhat controversial; most suggest surgical correction before age of 18 months, whereas others prefer to wait until after this age. Case Illustration: A 13-year old boy, presented with fusion of all fingers of the right hand at birth. Prior to his current visit, he underwent partial separation of the right fingers at the age of 6 y.o. at a local hospital. Following partial separation, the fingers did not grow normally. Current X-ray showed atrophy and deviation of middle phalanx. We performed separation of syndactyly between index and middle finger, and between fourth and small finger in our hospital. Interdigital webbings are released using local flap and the remaining raw surface is covered using full-thickness skin grafts. On follow up, the patient showed good functional and aesthetic outcome. He is able to write with his right hand with better coordination. Discussion: Complex syndactyly reconstruction is a challenging surgical problem. Common post surgical findings include rotational deformity, angular deformity, and nail deformity. We describe how we have altered our approach in these findings. Conclusion: Congenital syndactyly should be corrected early in life. Careful dissection, the use of a dorsal rectangular flap in combination with 2 volar triangular flaps, and use of full thickness skin grafts ensure a satisfactory outcome and minimize the number of operations per web.

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.

A COMPARISON OF ABBREVIATED BURN SEVERITY INDEX (ABSI) SCORE WITH R-BAUX SCORE AS A PREDICTOR OF MORTALITY IN BURN PATIENTS Iustitiati, Melissa Anita Ayu; Beta Subakti Nata’atmadja
Jurnal Rekonstruksi dan Estetik Vol. 7 No. 2 (2022): Jurnal Rekonstruksi dan Estetik, December 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jre.v7i2.41216

HIGHLIGHTS: 1. The R-Baux Score and ABSI Score can be used as model predictors of death in burn patients at Dr. Soetomo General Academic Hospital.2. There was no significant difference between the R-Baux Score and the ABSI Score as the predictor of mortality in burn patients. ABSTRACT: Background: Several studies regarding the mortality predictor model in burn patients have been carried out in several cities and countries. However, none have ever happened in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. This study aims to analyze the R-Baux Score and Abbreviated Burn Severity Index (ABSI) Score as a mortality predictor model in burn patients, which are relevant and useable in services at Dr. Soetomo General Academic Hospital. Methods: This study used quantitative research with a cross-sectional design and retrospective design utilizing secondary data. It was found that 263 patients met the inclusion criteria; with 73 patients died, 60.27% of whom were male, 50% with inhalation trauma, 19.18% were in the age range of 56-65 years old, 24.66% had a burn area of 61-70%, and 35.62% with a full-thickness burn. Results: The results showed that the sensitivity value from the ABSI Score (p<0.001) was 82.19%, with a specificity of 82.11%, a positive predictive value of 63.83%, and a negative predictive value of 92.31%. The R-Baux Score (p<0.001) showed that the sensitivity value obtained was 80.82%, with a specificity of 80.00%, a positive predictive value of 60.83%, and a negative predictive value of 91.57%. Conclusion: There was no significant difference between the R-Baux Score and the ABSI Score as the predictor of mortality in burn (p>0.05). Therefore, both the R-Baux Score and the ABSI Score can be used as model predictors of death in burn patients at Dr. Soetomo General Academic Hospital.

A COMBINATION TECHNIQUE OF AUTOLOGOUS AUGMENTATION AND BREAST LIFTING IN HYPOPLASTIC-THIRD GRADE PTOTIC BREAST: A CASE REPORT Beta Subakti Nataatmadja; Amatullah, Nida' Fahima; Lumintang, Loelita Marcelia
Jurnal Rekonstruksi dan Estetik Vol. 9 No. 2 (2024): Jurnal Rekonstruksi dan Estetik, December 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jre.v9i2.54614

Highlights: This case shows autoaugmented mastopexy as a natural alternative to silicone implants for patients seeking breast enhancement. The combination of breast lift and autoaugmentation using the patient’s own tissue is presented as an effective method for achieving a firmer breast appearance while maintaining a natural look. The use of tailored preoperative design, including breast ultrasound, enhances surgical safety and outcomes. Abstract: Introduction: Breast ptosis is a common concern among women due to factors such as aging, pregnancy, breastfeeding, and weight loss. To achieve a beautiful breast shape, mastopexy (breast lift) with augmentation is often required. This case report highlights the relevance of the chosen augmentation method in addressing ptosis. Case Illustration: A 30-year-old woman had breast ptosis after her 2nd child and wanted a breast lift to have lifted and firmer breasts. Due to limited fat tissue available for transfer and her refusal to use silicone implants, the patient chose autoaugmented mastopexy. Before surgery in August 2022, breast ultrasound showed abnormalities. Preoperative design was made to determine skin and pedicle positions, using a wise pattern with a superior pedicle to lift the nipple-areola complex (NAC) and an inferior pedicle for autoaugmentation. Surgery was done carefully to achieve symmetry and desired result. Discussion: Breast tissue changes a lot during and after pregnancy and hormonal factors increases the risk of ptosis. According to Regnault classification, the patient was classified as 3rd degree ptosis. While prosthetic implants are common in breast surgery, the patient declined that option. Autoaugmented mastopexy offers a more natural result without the risks of implants. Conclusion: Breast lift with autoaugmentation is suitable for patients with breast ptosis seeking a firmer appearance without added volume. This technique utilizes the patient's own tissue to achieve satisfactory results, although outcomes may vary depending on individual factors.

Co-Authors Agus Santoso Budi, Agus Santoso Amatullah, Nida' Fahima Asmaradianti, Aryunidya Fabian, Pascalis Iswinarno Doso Saputro Iustitiati, Melissa Anita Ayu Kusuma, Diana Murtiati LOELITA MARCELIA LUMINTANG, LOELITA MARCELIA Lumintang, Loelita M Muharram, Arif Rahmat Rizaliyana, Sitti Wahyu Nugroho, Thomas Eduardus Sudrajat Zarasade, Lobredia

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