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A FLAP MODALITY FOR RESURFACING FOLLOWING EXTERNAL GENITALIA TUMOR ABLATION: A CONSECUTIVE CASE SERIES Muzakkie, Mufida; Amatullah Sakinah, Annisaa Nabila
Jurnal Plastik Rekonstruksi Vol. 10 No. 1 (2023): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jprjournal.v10i1.358

Introduction : External genitalia defect may result from various cases such as vulvar cancer, cervical cancer, tumor metastases, etc. Female genitalia is challenging for reconstruction due to many complex anatomical structure like urethra, vagina, anus, and its a highly mobile region. It is need to reconstruct with high successful rate and low morbidity procedure. The aim of this paper is to report various flaps for resurfacing following external genitalia defect. Method : From September 2017 - April 2022, 7 patients referred by Obstetric Gynecology Department to Plastic Surgery Division at Muhammad Hoesin Central General Hospital. The data was reviewed retrospectively to evaluate demographic, diagnosis, choice of flap reconstruction, functional and anatomical long term evaluation. Result : The ages of the patients ranged from 29 - 67 year-old, diagnosed with cervical cancer with tumor metastases to vulva in 16% (n=1) and vulvar carcinoma 84% (n=5). Flaps performed: Antero-lateral Thigh (ALT) flap in 14,5% (n=1), gracilis flap in 28,5% (n= 2), rotation flap in 28,5% (n= 2), keystone flap in 28,5% (n=1). A major dehiscence and need required reoperation for abscess in 16% (n=1). Flap selection based on size, region, and anatomical structure defect. ALT was chosen for wide and bilateral vulvar and perineal defect, gracilis for unilateral vulvar and perineal defect, Keystone flap for half of vulvar and perineal defect, rotation flap for defect on mons region. Conclusion: Flap selection in genitalia external reconstruction must be consider on the anatomical loss structure and defect size to achive durable tissue for acceptable functional and mobilisation. The algorithm may help to choose for flap based on loss area.

Results of Measuring Lactate Levels Value in Free Flap Reconstruction Muzakkie, Mufida; Adhania, Karnissa Rizkia
Jurnal Plastik Rekonstruksi Vol. 11 No. 1 (2024): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25251/k4cg2w54

Introduction : Free flap surgery which is performed by transferring tissue along with its vascularization, can fail due to vascular compromised which cause by thrombosis formation either in vein or artery. Disruption of blood flow patency that not treated immediately can cause ischemia and necrosis occurred in free flap, especially within five days after reconstruction. Previous study has proven that free flap monitoring with lactate levels measurement can accurately for evaluate the occurrence vascular compromised in free flap. Method : This study is a descriptive observational study with cross-sectional design. It was conducted by observing medical record of free flap reconstruction patient from November 2022 until November 2023 at Plastic and Reconstructive Surgery Department of RSUP Dr. Mohammad Hoesin Palembang. Data collection was carried out using total sampling technique and analysed using Statistical Package for the Social Science (SPSS) version 22.0 with univariate technique. Result : Free flap with vascular compromise has higher lactate levels value than viable one. Lactate levels value transition of viable free flap showed an increase after anastomosis and gradually decrease at the next assessment time, while lactate levels in free flap with vascular compromise increased to above reference value, mainly on the first day vascular compromise occurred. Conclusion: Clinical monitoring which combined with lactate levels assessment can accelerate the diagnose of blood flow patency disruption in free flap so that cause success rate improvement and better prognosis of free flap reconstruction patients.

Analysis of Morphometric Variations in the Thickness of the Mandibular Symphysis in Patients at Dr. Mohammad Hoesin General Hospital Palembang, Indonesia Muzakkie, Mufida; Muhammad Fikri Aulia; S.N.A. Ratna Sari Devi; Ziske Maritska
Sriwijaya Journal of Surgery Vol. 7 No. 1 (2024): Sriwijaya Journal of Surgery
Publisher : Surgery Department, Faculty of Medicine Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjs.v7i1.96

Introduction. Accurate knowledge of mandibular thickness is necessary for performing surgical treatments on the mandible. The Champy procedure has become the predominant approach for treating fractures of the mandible. Placing plates along these lines is believed to offer the best possible fixing and stability. The objective of this study is to analyze and compare the thickness of the mandible in patients, specifically depending on their gender. The purpose is to gain a more comprehensive understanding of the differences in mandibular architecture across various populations in South Sumatra, Indonesia. Methods. This study is a cross-sectional analytical-observational study. The Department of Radiology of Dr. Mohammad Hoesin Central General Hospital, located in Palembang, conducted the study. We included a total of 103 research participants in this study, all of whom met the specified inclusion criteria. Results. There is a notable difference in the thickness of the lower jawbone in the front part (A and B) that runs parallel to Champy's line, depending on the person's gender. Males have a greater morphometric thickness of the mandibular symphysis in comparison to females. The thickness of the mandibular symphysis closely links to gender disparities. Conclusion. The thickness of symphysis A in men was substantially greater than in females, while the thickness of symphysis B in males was also significantly greater than in females, with a P value less than 0.001.

Predicting Free Flap Viability: Integrating Lactate and Glucose Measurements with Artificial Intelligence Muzakkie, Mufida; Murti, Krisna; Nurmaini, Siti; Soedjana, Hardi Siswo
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.v12i1.388

Introduction: In reconstructive surgery, free flaps are a superior method for resurfacing defects. While free flap viability is typically monitored by subjective clinical examination, lactate and glucose levels in free flaps, which can affect tissue metabolism during ischaemia and reperfusion, can help predict viability. This study aims to review previous research and provide a theoretical basis for using artificial intelligence in lactate and glucose measurement as a means of assessing flap viability.Method: The primary databases used to retrieve the key medical literature presented in this study were book references and Google Scholar, PubMed and Science Direct, using search terms related to the topic. Only articles written in English and published less than ten years ago were included.Results: Lactate levels detect perfusion impairment earlier than clinical signs or other biochemical markers while glucose monitoring can indicate underlying metabolic dysregulation or physiological stress, helps early detection of complications. Combining lactate and glucose measurements enhances diagnostic accuracy and allows for timely interventions for flap viability. Studies confirm this dual monitoring is a practical, unbiased, and has the potential to be developed into an artificial intelligence tool to improve patient outcomes.Conclusion: Lactate and glucose measurements in free flap monitoring have distinct benefits. Lactate detects ischaemia and reflects tissue metabolism, while glucose monitors energy metabolism and systemic health. Combining these leading to improved flap survival rates. With accessible tools, this approach improves patient care and outcomes in reconstructive surgery.

Results of Measuring Lactate Levels Value in Free Flap Reconstruction Muzakkie, Mufida; Adhania, Karnissa Rizkia
Jurnal Plastik Rekonstruksi Vol. 11 No. 1 (2024): (2024) 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.v11i1.374

Introduction : Free flap surgery which is performed by transferring tissue along with its vascularization, can fail due to vascular compromised which cause by thrombosis formation either in vein or artery. Disruption of blood flow patency that not treated immediately can cause ischemia and necrosis occurred in free flap, especially within five days after reconstruction. Previous study has proven that free flap monitoring with lactate levels measurement can accurately for evaluate the occurrence vascular compromised in free flap.Method : This study is a descriptive observational study with cross-sectional design. It was conducted by observing medical record of free flap reconstruction patient from November 2022 until November 2023 at Plastic and Reconstructive Surgery Department of RSUP Dr. Mohammad Hoesin Palembang. Data collection was carried out using total sampling technique and analysed using Statistical Package for the Social Science (SPSS) version 22.0 with univariate technique.Result : Free flap with vascular compromise has higher lactate levels value than viable one. Lactate levels value transition of viable free flap showed an increase after anastomosis and gradually decrease at the next assessment time, while lactate levels in free flap with vascular compromise increased to above reference value, mainly on the first day vascular compromise occurred.Conclusion: Clinical monitoring which combined with lactate levels assessment can accelerate the diagnose of blood flow patency disruption in free flap so that cause success rate improvement and better prognosis of free flap reconstruction patients.

Morphometric Variation of Maxilla in Mohammad Hoesin General Hospital Muzakkie, Mufida; Toline, Lawrencia; Devi, Ratna Sari; Maritska, Ziske
Jurnal Plastik Rekonstruksi Vol. 11 No. 2 (2024): (2024) 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.v11i2.389

Background: Morphometry is a quantitative approach to finding information about variations in the shape of organisms. The maxilla has a central position and plays a vital role in supporting the viscerocranium. Morphometric variations are beneficial in reconstructive procedures and are an essential reference in plastic surgery. However, this study is currently limited. This study aims to determine variations in the maxillary morphometry of patients at Mohammad Hoesin General Hospital that may become a reference for maxillary reconstruction. Method: This descriptive observational study with a cross-sectional approach aims to identify variations in maxillary morphometry in patients treated at RSUP Mohammad Hoesin Palembang. The study is directed at describing a community or society to create an objective picture or description of a condition. It continues by analyzing and comparing maxillary morphometry based on gender. Results: In this study, the results were obtained from as many as 96 samples (male, n = 60, female, n = 36). Variable of male and female were assessed, namely intercanine width (3.58 ± 0.27cm; 3.44 ± 0.18cm), intermolar width (5.64 ± 0.43cm; 5.47 ± 0.27cm), arch length (3.31 ± 0.38cm; 3.32 ± 0.31cm, and palate height (2.46 ± 0.28cm; 2.35 ± 0.22cm) significant results were obtained that the dimensions of the male maxilla were more significant than those of females. Conclusion: There are variations in maxillary morphometry based on gender. Males have larger inter canine width, intermolar width, and palate height morphometry than females.

Comparison of Morphometric Variation of Ramus Length and Mandibular Corpus Length in Patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia, Based on Gender Muzakkie, Mufida; Muhammad Febriandi Djunaidi; S.N.A Ratna Sari Devi; Ziske Maritska
Sriwijaya Journal of Surgery Vol. 6 No. 2 (2023): Sriwijaya Journal of Surgery
Publisher : Surgery Department, Faculty of Medicine Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjs.v6i2.87

Introduction: Planned mandibular reconstruction with the help of morphometry allows plastic surgeons to perform operations with greater precision. They can plan bone shifts and cuts more accurately, minimize damage to surrounding tissue, and achieve cosmetically and functionally better results. This study aimed to compare the morphometric variation of ramus length and mandibular corpus length in patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia, based on gender. Methods: This study was a cross-sectional analytic observational study. A total of 96 research subjects participated in this study, where the length of the ramus and corpus of the mandibular was obtained by assessing the 3D CT scan of the mandibular. Data analysis was carried out using SPSS in a bivariate. Results: The length of the mandibular ramus dextra and sinistra shows that the male gender is longer than the female gender, where the p-values are 0.000 and 0.001, respectively (p<0.05). The length of the mandibular corpus dextra and sinistra did not show a statistical difference in length, where the p-value was > 0.05. Conclusion: There is a difference in the length of the mandibular ramus between men and women, but there is no significant difference between the length of the corpus mandibular between men and women.

Multigravida at 31 Weeks with Imminent Preterm Labor, Type 2 Diabetes Mellitus, Maxillary Abscess, and Bad Obstetric History : A Case Report Sentani, Ray Suga Aulia; Bernolian, Nuswil; Muzakkie, Mufida; Kusnadi, Yulianto
Sriwijaya Journal of Medicine Vol. 8 No. 3 (2025): Vol 8, No 3, 2025 (Issue In Progress)
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/sjm.v8i3.351

Imminent preterm labor (IPL) is defined by irregular uterine contractions, back pain, and vaginal discharge, with approximately 25-30% of cases progressing to preterm delivery. Preterm birth remains a major global issue, contributing to 35% of neonatal deaths, and often results in long-term health complications for the infant. This case report discusses a 35-year-old woman (G4P2A1) at 30 weeks of gestation, with a history of type 2 diabetes mellitus (T2DM), bad obstetric history (BOH), and a right maxillary abscess. She presented with swelling and pus discharge from the maxillary region, along with abdominal cramps, but no signs of imminent labor. The patient’s diabetes was managed with insulin, and her clinical condition was complicated by high blood glucose and an ongoing infection. The cervical length was measured via ultrasound, which indicated a risk for preterm delivery, and the patient was diagnosed with IPL. Initial management included fluid resuscitation, tocolytics to prevent labor, and antibiotics for the maxillary abscess. The patient was closely monitored, and insulin therapy was adjusted to stabilize glucose levels. Despite the complexity of managing IPL in diabetic patients, the patient's condition improved after debridement of the abscess and management of blood glucose levels. This case emphasizes the importance of multidisciplinary care in managing complicated pregnancies with comorbidities like T2DM.

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