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All Journal Indonesian Journal of Urology Jurnal Rekonstruksi dan Estetik
Kale, Letitia Bellavesta
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Health Professions Medicine & Pharmacology Public Health

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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.
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.
Co-Authors Ali, Ahmed Mohamed Ahmed Angela Djunaedi Arley Sadra Telussa Datusanantyo, Robertus Arian Kumar, Kundan Malelak, Elric Brahm Thumar, Dhyey Ullah, Wajahat