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All Journal Medical Journal of Indonesia Jurnal Plastik Rekonstruksi

Sudjatmiko, Gentur

Department of Surgery, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta

Author-ID : 669531

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

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Comparison of Physical–Chemical Characteristic and Antibacterial Effect Between Manuka Honey and Local Honey Sundoro, Ali; K., Nadia; A., Nur; Sudjatmiko, Gentur; Tedjo, A.
Jurnal Plastik Rekonstruksi Vol. 1 No. 3 (2012): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background:Honey has positive effects on wound healing due to its properties to decrease inflammatory reaction, assist wound debridement, lessen wound odor, help moisturize the wound, promote wound healing and has antibacterial effect. In this research we try to confirm the benefit of using Indonesian local honey by comparing its efficacy with Manuka honey, which is already known yet still costly and not readily available in Indonesia.Methods: Two kinds of honey above were compared for its physical and chemical properties of antibacterial effects and safety, its acidity (pH) using pH meter, osmotic pressure with indirect measurement using hygroscope and hydrogen peroxide concentration using hydrogen peroxide strip test, also for its bacterial contents using standardized microbiological culture.Results: The measurements of the water activity, pH level,production of hydrogen peroxide, also the bacterial content, showed that there is no significant difference between the manuka honey and the local ones.Discussion: Both of the honey pH levels are still within the normal range of honey pH level (3.5-4.5) which still have the antibacterial properties to inhibit bacterial growth. Both of the honey water activity level are still within the normal range of honey water activity level (0.500–0.650) which still have the antibacterial properties to inhibit bacterial growth. Manuka honey has been known as non peroxide honey that didn’t produce any hydrogen peroxide.Conclusion:Indonesian local honey which has been used in this research has a similar physical–chemical characteristic as Manuka honey; making it a very good alternative source of medicinal honey because of its affordability and availability.

The Effect of Honey on Granulating Tissue of The Mandibular Bone Harsono, Anastasia Dessy; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 3 (2012): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: For many years, ancient civilizations used honey to heal wounds. Rediscovery of honey by modern physicians its use in conventional medicine. Few detailed descriptions of honey in healing difficult surgical wounds have been previously published.Methods: We report patient, male, 16 years old, who suffered acute lymphocytic leukemia and extensive mandibular eschar and had presented half of mandible bone exposed after escharectomy. Given the of closing the defect due to poor general condition of the patient, we advocated to applicate honey dressing on mandible bone to promote granulation tissue, to prevent infection and to promote epithelialization.Results: Due to honey’s effect are anti inflammatory and antimicrobial activity, promotes debridement, reduces malodor, maintains moist wound environment, and stimulates healing, in a month, all mandible exposed had been covered by granulation tissue, followed by skin grafting.Conclusion: In this case, honey had been proven effectively to stimulate granulation tissue growth on mandible bone both before and after surgery.

Acromiocervical Flap As One of the Modality To Reconstruct Post-Burn Neck Contracture: A Case Report Irwansyah, Denny; Sandhi, Afriyanti; Heryadi, Eko; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 4 (2012): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Abstract: Postburn neck contractures are frequent and may cause gross facial deformity and severe functional disability. Reconstruction of these deformities is challenging, especially to plastic surgeon. Several methods have been published including skin graft, local flap and free flap. Patient and Method: The case presented in this paper is a postburn neck contracture which had been managed by two plastic surgeons in two different hospitals. This deformity limits the normal function of eating, speaking and appearance of this patient. Skin graft was used to correct this deformity but in the next few months neck contracture recurred. Result: It results in minimal disability and in overall improved functional and appearance outcome. We report our experience using the acromiocervical flap on a case for reconstruction of neck contracture with a goal to prevent recurrence.Summary: Skin Grafting is not an easy and simple procedure for reconstruction of the neck contracture. It requires comprehensive rehabilitation program including prolonged neck splinting and patient compliance. Considering those difFIculties acromiocervical flap can be one of the modality to reconstruct post burn neck contracture because it is relatively simple and reliable.

Management and Treatment of Gynecomastia with Liposuction Sari, Tessa Puspita; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 4 (2012): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Gynecomastia is a common problem of the male breast, with a reported overall incidence of 32 to 36 percent. The surgical management of gynecomastia has undergone significant changes over the past few decades, from a predominantly open approach to one involving liposuction only or liposuction combined with direct excision through a periareolar or remote incision. Patients and Method: We present five cases with bilateral gynecomastia. One patient is a teenager and others are adult males. Liposuction only was performed in patients without palpable glandular breast mass. Direct excision was made to help remove the excessive glandular breast mass. The compressive garment is worn for 4 to 6 weeks after procedure to prevent the complications of the surgical procedure.Result: Three of the patients are corrected with liposuction only. There are two patients who underwent combination of open excision and liposuction. The liposuction procedure only left minimal scar from canulas incision. Other patient has minimal periareolar incision to remove excess breast tissue. None of the patients showed complication after surgery.Summary: All of the patients presented were satisfied by the correction of gynecomastia using liposuction. None of the patients shows any complication after liposuction procedure. The result after surgery is a natural-looking chest without extensive scar. The patients appreciate the early return to work and normal physical activities.

The Extended Lateral Forehead Flap: Today as Was 50-years Ago Supit, Laureen; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 4 (2012): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: In the era of surgical advances where institutional pride and status resonates with their progress in the minimal invasives, latest technologies, stem cells, and supermicrosurgeries; some things in plastic surgery never change. The extended lateral forehad flap (ELFF) was first introduced by Ian McGregor in 1963 to reconstruct an intraoral defect, he called it the temporal flap. Gillies and Millard each modified and utilized the flap for patching various facial and intraoral defects and published their experience a year later. Until today in 2012, the ELFF is still largely useful for the reconstruction of wide defects post neoplasms ablation in the face or oral region, which would otherwise require distant flaps or free flaps.Patients and Methods: Three cases of oral and perioral carcinoma were resected and reconstructed using the ELFF to cover for: a full-thickness cheek defect including the lip commisure, an inner oral lining, and a hemipalatal defect.Results: In all, the flaps were tunneled subcutaneously, and donor area grafted by full-thickness skin. All flaps survived and functional outcomes are attained in all patients, with acceptable aesthetic results.Summary: A flap once introduced 49 years ago, is today as consistent and applicable in plastic surgery. This article is an appraisal to the ELFF, and a reminder to the general plastic surgeons, of the simple yet versatile role of ELFF in the reconstruction of facial and intraoral defects.

Secondary Rhinoplasty On Cleft Lip Nose Sudjatmiko, Gentur; Kreshanti, Prasetyanugraheni
Jurnal Plastik Rekonstruksi Vol. 1 No. 4 (2012): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

By definition a secondary rhinoplasty is a procedure to correct the nasal shape deformity in cleft lip patients, which is performed not in conjunction with the labioplasty procedure. Several important factors to be considered in doing rhinoplasty procedures in cleft lip patients are: (1) Open rhinoplasty is more beneficial in assessing the whole nasal deformity, especially the nasal cartilage in cleft lip patients, (2) Releasing the latero-superior cartilage attached to the nasal bone and skin, which caused webbing inside the nostrils, (3) Addition of strut in columella as a pillar to adjust the dropping nose to the upright position, (4) Addition of cartilage plate whenever needed in the cleft side, (5) The nostril narrowing on the cleft side could be reduced by enlarging the nostril diameter, (6) The new nostril shape is maintained using a device (nasal retainer) for several weeks until the healing process is achieved, (7) The suture removal in nose is not as easy as of those in lip. The suture removal could be performed under mild sedation especially in uncooperative patients.

Comparison of Wound-bed Preparation Time in Chronic Traumatic Wound Using Topical Honey Application and Conventional Dressing Mukarramah, Dewi A.; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 4 (2012): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Prior to the de!nitive closure of wound by skin graft, it is essential for the recipient wound to be prepared adequately. Honey has been shown to exert a valuable effect in wound healing, atributale to its six favorable characteristics. This clinical study is proposed to determine the effectiveness of a specific sample honey (Madu Nusantara®) in accelarating the time of wound bed preparation in chronic traumatic wound.Methods: A randomized non-blinded clinical trial was done on patients with chronic traumatic wound who required wound bed preparation before definitive closure, during a one-year period. A total of 18 patients were included in the study, divided into two interventions. One has wound treated by topical application of honey (HDR), and controls were treated by conventional dressing (CDR). Daily wound treatment and evaluation was done using The Bates-Jensen Wound Assesment Tool until wound-bed was ready to be skin-grafted. The time required until wounds were ready to be grafted was also measured in both groups.Results: The mean time of wound bed preparation in HDR gorup was 12 days (n=11), and 26 days in CDR group(n=7, p 0.0055). The mean Bates-Jensen score of HDR improved from 45.45 before treatment to 23.36, versus 44.00 to 29.00 in CDR subjects.Conclusion: A favorable wound bed is essential prior to skin grafting.Our data shows that topical application of honey is more effective in accelerating the time of wound bed preparation than conventional dressing in patients with chronic traumatic wound.

Our Appreciation Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 1 (2012): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jpr.v1i1.95

May wellbeing, compassion, and abundance be blessed upon us always

Curettage and Policresulen Tampon as A Modality Treatment in Management of Verucca Simamora, Huntal; Lestari, Puri Ambar; Bangun, Kristaninta; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 5 (2012): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Verruca, also known as warts is a skin disease characterized by epidermal growth. Verruca may occur anywhere especially on palms and soles. It appears as a rough, dark-grey colored surface and has similar features with clavus or callus, which frequently lead to inappropriate management.Patient and Method : We report two cases with verruca, one was on sole and another was on palm area treated with curettage and chemical ablation using policresulen solution. Both cases have histories of recurrences from the previous treatment, which was excision and primary closure.Results : The wound healed within seven days after treatment. There were no recurrences found after 6-month follow up.Summary : Our treatment (curettage and chemical ablation using policresulen) has two advantages: (1) it can avoid excessive tissue removal since this lesion only afect epidermal layer.

Management of Patient with Closed Degloving in the Pelvic Region: a Case Series Atmadja, Tessa Miranda; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 5 (2012): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Degloving injuries in pelvis, torso and extremities present a challenge in wound management. Current management usually is the effort to provide wound coverage with split thickness skin graft (STSG). Problems arise in the wound bed preparation because the patient is not mobile, urine or feces contamination, and systemic problems such as anemia, hypoalbuminemia and sepsis. After wound coverage with STSG, problems arise during postoperative period caused by dificulty to maintain immobilization of the graft due to the location.Patients and Methods: In January to February 2012, 3 patients were admitted to Cipto Mangunkusumo hospital with degloving in the pelvic region. They were treated with delayed STSG.Results : The first patient underwent delayed STSG with a 75% take. The second patient was treated by serial STSG a month following hospital admission, the result was almost 90% take. The last patient underwent debridement and the wound was closed with STSG 10 days after admission, the result was only 50% take.Summary : Management of degloving patients should include adequate wound bed preparation with dressing that minimize infection and enhance good granulation tissue, maintain good systemic condition by providing adequate nutrition with care to albumin and electrolyte loss. Care should be given to prevent SIRS and sepsis. After wound coverage with STSG, modalities to immobilize the graft and maintain ideal environment for graft take have to be considered.

Co-Authors A., Nur A., Teuku Anggrahita, Tasya Anindhawati, Nur Atmadja, Tessa Miranda Bangun, Kristaninta Buchari, Frank D., Ishandono Djaprie, Shelly M Djoenaedi, Intania eko heryadi, eko Hakim, Intan Frischilla Hakim, Intan Friscilla Harsono, Anastasia Dessy Ibadurahman, Ibadurahman Irwansyah, Denny K. P., Ayu Diah K., Nadia Kreshanti, Prasetyanugraheni Kusumastuti, Nadia Laureen Supit Lestari, Puri Ambar Mahandaru, Danu Marita, Adinda Mukarramah, Dewi A. Mukarramah, Dewi Aisyah P., Nandita Melati Pribadi, Sweety Rani Septrina Raymond, Benni Raymond, Benny S., Asrofi Sandhi, Afriyanti Sari, Tessa Puspita Simamora, Huntal Sundoro, Ali Tania, Vika Tedjo, A. Tiza, Melina Utama, Defry Yundari, Yundari

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