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All Journal Universa Medicina Jurnal Plastik Rekonstruksi
Marcevianto, Kevin Varian
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Civil Engineering, Building, Construction & Architecture Health Professions Immunology & microbiology Medicine & Pharmacology Public Health Other

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The Outcome of Keystone Flap for Lower Extremity Defects: A Systematic Review Marcevianto, Kevin Varian; Wardhana, Aditya; Putri, Nandita Melati
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.v11i2.373

Abstract

Introduction : Lower extremity defect poses a significant challenge in reconstructive surgery due to the limited usability of soft tissue. The keystone flap which utilizes fasciocutaneous perforators, has emerged to be a potential technique in fixing soft tissue defects. However, scientific evidence, specifically on its effectivity and complication rate in lower extremity defect is lacking. Therefore, this systematic review aims to assess the outcome and potential complications correlated to the use of Keystone Flap in repairing lower extremity defect. Method : This systematic review was done in accordance to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Literature searching was conducted using four databases, which is PubMed Central, Embase, Scopus and Cochrane Library. Result : A grand total of sixteen studies were included in the review. Among it, fourteen studies were case series. The others were cohort prospective and single arm interventional studies. Out of the 662 keystone flaps used, a total of 129 complications (19.5%,) were recorded, with the majority being infection or cellulitis (5%, n=33), delayed healing (4.5%, n=30), wound dehiscence (4.3%, n=28), and partial flap loss or necrosis (2%, n=13). Conclusion: The keystone flap could be an alternative for lower extremity defect with a realtively low complication rate.
Validity of core needle biopsy in diagnosing primary thyroid lymphoma: a systematic-review and meta-analysis Sanjaya, Nadira Prajnasari; Marcevianto, Kevin Varian; Sanjaya, Indira Saraswati; Kohar, Kelvin; Nufus, Hayatun
Universa Medicina Vol. 45 No. 1 (2026)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2026.v45.153-165

Abstract

BackgroundPrimary thyroid lymphoma (PTL) is a rare thyroid malignancy, accounting for less than 5% of thyroid malignancies. The prognosis of PTL depends on the histologic subtype and stage of disease at diagnosis, hence an effective diagnostic method is needed to ensure prompt treatments. Fine needle aspiration (FNA) is the first test for microscopic examination of a rapidly enlarging thyroid mass, but its limitations and low sensitivity have been observed.  After the often “inconclusive” result is known, core-needle biopsy (CNB) should be performed as the natural next diagnostic step. This systematic review and meta-analysis aimed to evaluate the diagnostic value of core needle biopsy (CNB) in diagnosing PTL. MethodsThis systematic review and meta-analysis follows the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. A PubMed and Embase database search was performed in August 2025. Populations included were patients with final diagnosis of PTL. Pooled sensitivity was calculated using a random-effects model. ResultsThis systematic review and meta-analysis of 12 studies comprised a total of 1091 patients. Core needle biopsy proved to be highly effective, with a pooled sensitivity of 91.6% (95% CI: 82.1%–96.3%). The development of tumor-cell seeding following CNB has been a major concern, but this complication is extremely rare. Other potential complications include bleeding and infection. ConclusionCore needle biopsy demonstrates high diagnostic sensitivity and a favorable safety profile in diagnosing primary thyroid lymphoma, supporting its role as a valuable diagnostic modality, particularly when PTL is clinically suspected or FNA results are inconclusive.
Co-Authors Aditya Wardhana Hayatun Nufus Kohar, Kelvin Putri, Nandita Melati Sanjaya, Indira Saraswati Sanjaya, Nadira Prajnasari