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Jurnal Plastik Rekonstruksi

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Published by Yayasan Lingkar Studi Bedah Plastik

ISSN : 20896492 EISSN : 20899734 DOI : -

Core Subject : Education, Engineering,

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Jurnal Plastik Rekonstruksi is an open access, peer reviewed, international journal focusing on global plastic and reconstructive surgery. JPR publishes on all areas of plastic and reconstructive surgery, including basic science/experimental studies pertinent to the field and also clinical articles on such topics as: breast reconstruction, head and neck surgery, pediatric and craniofacial surgery, hand and microsurgery, wound healing, and cosmetic and aesthetic surgery. Clinical studies, experimental articles, ideas and innovations, and techniques and case reports are all welcome article types.

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Articles 250 Documents

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Incomplete Cleft Palate in Cornelia de Lange Syndrome Fortuna, Fory; Kreshanti, Prasetyanugraheni; Handayani, Siti; Bangun, Kristaninta
Jurnal Plastik Rekonstruksi Vol. 2 No. 1 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Cornelia de Lange Syndrome (CdLS) is a rare congenital anomaly inheritance syndrome. The prevalence is 1.6-2.2/100.000 of 8,558,346 births in Europe. Cleft palate is less frequent malformation of this syndrome (21,7%) than other associated malformations. The diagnosis can be obtained clinically based on CdLS diagnostic criteria by USA CdLS Foundation. This is the first case in our hospital. Patient and Method: A case of a 4-year-old girl who came to our attention at Cleft and Craniofacial Center Cipto Mangunkusumo National General Hospital for incomplete cleft palate. Parents’ major concerns was feeding problem. The clinical investigations showed that the child met diagnostic criteria for CdLS as described in literatures. We manage this case in collaboration with paediatric department and other related specialists, including radiologist and craniofacial orthodontist. We performed Veau-Wardill-Kilner’s palataoplasty for the incomplete cleft palate. Paediatric department arranged provision of dietary. Result: This patient with incomplete cleft palate whom we treated by palatoplasty was moderately involved by CdLS (severity score 17). After 3 weeks follow-up, we have overcome feeding problem and body weight gained. Summary: Patient with CdLS needs early multidisciplinary team approach management for maximum outcome, because variety of associated malformations may present and life-threatening. Diagnostic criteria by USA CdLS Foundation assist health care personnel recognize this syndrome early.

Distraction Osteogenesis for Micrognathia in Cipto Mangunkusumo Hospital : A Case Series Boaz, Grace; Kreshanti, Prasetyanugraheni; Handayani, Siti; Bangun, kristaninta
Jurnal Plastik Rekonstruksi Vol. 2 No. 1 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Micrognathia is usually associated with genetic syndromes, characterized by mandibular hypoplasia causing a receding chin. The overall incidence of micrognathia was 1 per 1600 births, makes it a rare case. Severe micrognathia can be a neonatal emergency due to airway obstruction by the tongue in the small oral cavity. One method for correcting micrognathia is distraction osteogenesis. Lack of experience due to rare incidence of case, expensive cost of distraction device and technical complexity of the operation can be obstacles to this management. Patient and Method: We report two cases of micrognathia corrected with distraction osteogenesis conducted in Cipto Mangunkusumo Hospital from 2011-2012. The method consists of implantation of bilateral distraction device to the inferior border of the mandibular body. The patients then followed postoperatively. Result: Mandibular lengthening by gradual distraction is a proper method for young patients with micrognathia. Despite our minimal experience and intricate kind of method, we are trying to improve our skill in the future. Summary: Distraction osteogenesis is one method for correcting congenital mandibular hypoplasia.

Randomized Control Trial Comparing Moist Exposed Burn Ointment and Honey as Dressings Agents in Patients with Second -Degree Burns Harsono, Anastasia Dessy; Wardhana, Aditya
Jurnal Plastik Rekonstruksi Vol. 2 No. 1 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Many topical agents are available for the treatment of partial thickness burns. We examined Moist Exposed Burn Ointment (MEBO) and honey as dressing agents; regarding their natural antibacterial, anti-inflammatory, and wound healing properties. They have also been proven to be superior than silver sulphadiazine in treating burn wound.Methods: A total of 34 patients were randomly allocated into MEBO group and Indonesian local honey group. The dressings are changed daily, with corresponding interventions applied. The depth and extent of burn wounds were assessed upon patient’s admission and once a week for two weeks. Pain level was evaluated using the Numeric Rating Scale (NRS). The wound swabs were cultured weekly to obtain microorganisms profile. The cost-per-day of each group were counted.Result: Acute partial thickness burn in MEBO group showed faster healing compared to honey group. NRS scores for pain were also lower in MEBO group. MEBO was found to be more effective in decreasing bacterial colonization. Cost of treating wound using MEBO until complete healing was also lesser than local honey.Conclusions: As topical agent to treat partial thickness burns, MEBO is superior compared to local honey due to faster healing, better pain relief, fewer bacterial colonization and the more cost-effective usage.

Abdominoplasty: A Proposal of Results by Measurement Susanto, Imam
Jurnal Plastik Rekonstruksi Vol. 2 No. 1 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Among body contouring procedures, abdominoplasty is a procedure, which cosmetic surgery patients seek most frequently. The aim of abdominoplasty is to fulfill the ideal appearance of the abdomen without complication. Optimal results and proposed best accuracy measurement tool for abdominal dimension will be presented.Patients and Methods: Two female patients with abdomen type III and IV, underwent surgical correction with choice of total abdominolipectomy. Pre-operative and post-operative evaluations and photographs of patients were documented. Appearance of abdomen, quality of the scar, and navel were evaluated.Results: Total abdominolipectomy was performed in two cases of woman with abdomen type III and IV. All of the patients have shown abdominal dimension reduction and the result was good and satisfying. Author proposed a measurement including abdominal dimension in three different levels of circumference : midline point circumference between navel to xyphoid, navel level circumference, and anterior superior spina illiac level circumference, quality of scar, navel, and abdominal appearance, which are documented before surgery, three weeks after surgery and three months post surgery.Summary: Optimal outcome in abdominoplasty is determined not only by appropriate surgical technique, but also by the selection design, how the dissection is done, the excision, suturing technique, and post-surgical care treatment. Author proposed a measurement form evaluated by the surgeon, patient, and observer to collect more precise objective and subjective results.

Is The ‘Rule of Tens’ a Necessary Screening Criteria in Cleft Lip Surgeries Ibadurahman, Ibadurahman; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 6 (2012): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: The “rule of tens” (ROT) is still widely applied nowadays in many cleft centers worldwide for cleft lip surgery, although many surgeons do not implement it as a standard ru Recent advances in the field of anesthesiology have enhanced the safety of surgery for neonates. In Indonesia, ROT is still applied but is still flexible, due to some pertaining social confiicts. The relevance of ROT to the rate of mortality and morbidity is still unknown. This study aims to assess the need of using ROT in cleft lip surgeries.Methods: A retrospective study was conducted. Data was obtained from the medical records of patients who had undergone cleft lip repair between January 2004 to December 2005 in one day care setting. All data related to ROT parameters was categorized in two groups, either fit or unfit according to ROT criterias. The relationship of ROT to rate of associated morbidity and mortality was evaluated.Results: There were 204 cases of cleft lip repair with age range of 6-week to 12-year old. More than half (52.9%) was unfit for ROT. There were twelve cases of wound dehiscence and one total breakdown of the sutures, and no mortality. There were no statistically significant correlation ce between ROT and the rate of dehiscence. Conclusion: ROT is not a definitive criterion that could predict the success of cleft lip repair surgery.

The Role Of Coagulation Testing Prior To Surgery Cozie, Novie Amelia; Windiastuti, Endang; Gatot, Djayadiman
Jurnal Plastik Rekonstruksi Vol. 1 No. 6 (2012): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Preoperative coagulation screening has been among the most debated of all laboratory tests, especially in children. Although an undiagnosed coagulopathy could result in serious surgical morbidity, commonly used screening tests such as bleeding time, prothrombin time, activated partial thromboplastin time, and platelet count, do not reliably predict abnormal perioperative bleeding. Laboratory testing should be considered in patients either the history or medical condition suggests a possible hemostatic defect, in patients undergoing surgical procedures that might induce hemostatic disturbances (eg, cardiopulmonary bypass), when the coagulation system is particularly needed for adequate hemostasis (eg, tonsillectomy), and in patients for whom even minimal postoperative bleeding could be critical (eg, neurosurgery). In the case of minor surgery and a negative history of clotting disorders, no tests are suggested.

Lip And Palate Reconstruction On Median Cerebrofacial Malformation Patient Anindhawati, Nur; Kreshanti, Prasetyanugraheni; Handayani, Siti; Bangun, Kristaninta
Jurnal Plastik Rekonstruksi Vol. 2 No. 2 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Median cerebrofacial malformations are developmental anomalies of the midline brain and facial structures. The clinical manifestations ranges from holoprosencephaly with agenesis of central facial structures, to those seen in median facial dysplasia. Patients who survive are usually born with severe functional limitation and die during infancy. Nowadays, with improved perinatal care, patient with severe midline craniofacial abnormalities can be expected to live longer. The purpose of this paper is to show how reconstruction of the lip and palate on patient with median cerebrofacial malformation is done. Patient and Method: Reporting 2 cases of child with cleft median cerebrofacial malformations. First case was a 2 year-old child with complete median cleft lip and palate. Clinical examinations and CT scan revealed a holoprosencephaly. She was also diagnosed with laryngomalacia. The second case was a 4 month-old patient with median cleft lip and palate also microcephaly. We performed labioplasty in both patients and did the palatoplasty in the first patient. Result: Both cases showed no sign of complication after the operation. They both discharged one day after the operation. The first patient reported dead 1 week after the surgery at home. The cause was unknown. Discussion: Disturbed maxillary growth is postulated to be caused by the manipulation and suturing of the maxillary vomer, and scarring of the dentoalveoli post-surgery. Another contributing factor is the intrinsic tissue deficiency. Summary: With proper perinatal care and holistic teamwork that expand the survival rate we expect those with the best prognosis deserve to appear as normal as possible. Keywords: Holoprosencephaly, median facial dysplasia, median cleft lip and palate

The Incidence of Palatal Fistula Postpalatoplasty in Children with Dental Caries: A Multi Centre Study Utama, Defry; Buchari, Frank; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 2 No. 2 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Cleft lip and/or palate (CL&/P) is the most common congenital craniofacial abnormality, affecting approximately 1 in every 700 newborns. Patients with cleft lip and/or palate (CL&/P) generally display poor oral hygiene and a higher prevalence of caries. This may be due to the difficulty in achieving adequate plaque control associated with dental anomalies and defects from the lips and/or palate. Palatal fistula is a significant complication following cleft palate repair. It is the aim of this research to find correlation between palatal fistula and dental caries. Patient and Method: Patients with unilateral complete cleft palates admitted to the Cipto Mangunkusumo hospital, Adam Malik hospital within the period July 2012 till March 2013 were included in this study. All cases underwent modified two flap palatoplasty leaving lateral periosteum technique and follow-up were done in two weeks to see if there are any palatal fistula. Result: Thirty eight patients with unilateral cleft palate were enrolled in the study. Fifteen (39.5%) of them are boys and 23 (60.5%) are girls. Fifteen of the patients (41.7%) had dental caries, with six patients (40%) had palatal fistula in the follow up after palatoplasty, while there was none (0%) of the 21 (58.3%) patients that were found negative for dental caries developed a fistula. Conclusion: Dental caries is one of the important predisposing factors of palatal fistula in patients who undergo palatoplasty.

Revision of Bilateral Celft Lip Deformity Using Abbe Flap Djaprie, Shelly M; Kreshanti, Prasetyanugraheni; Handayani, Siti; Bangun, Kristaninta
Jurnal Plastik Rekonstruksi Vol. 2 No. 2 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Most primary repair of bilateral complete cleft lip does not show satisfying result due to several deformities caused by inappropriate use of the hypoplastic prolabial tissue, failure to advance the lateral lip elements to the midline for primary repair of the orbicularis, and scarring. The Abbe flap is the accepted procedure for the correction of severe secondary deformity of a bilateral cleft lip. By introducing an adequate amount of lip tissue, it relieves the tightness of the upper lip and also corrects the depressions of the tip of the nose. Symmetry between the two lip is also achieved Patient and Method: Three patients with tight lip deformity underwent this procedure. The Abbe flap, which was taken from the central portion of the lower lip vermilion, was designed to repair the vermilion tubercle and the Cupid’s bow. A tiny portion of skin was included to facilitate closure of the donor site. The pedicle was divided 3 weeks after operation. Results: Each patients showed a more natural contour of the vermilion tubercle and the Cupid’s bow. The scarring of the donor site was inconspicuous. Summary: The Abbe flap can be considered as a choice for revision of bilateral cleft lip deformity. The disadvantages of this flap include patient’s discomfort and the need for multiple procedures.

Pregnancy Unawareness and Risk Factors in Cleft Sari, Vania Aramita; Anggrahita, Tasya
Jurnal Plastik Rekonstruksi Vol. 2 No. 2 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background : The etiology of the cleft lip and palate (CLP) are still debated among researchers. Early pregnancy awareness is essential since the facial formation occurs in the first eight-week of gestation period. This study aims to compare pregnancy awareness and risk factors associated with CLP. Method : A descriptive cross-sectional study on 103 mothers whose child suffered from non-syndromic CLP (cases) was compared to 157 mothers whose child is normal (control). Parameters evaluated were pregnancy awareness during early pregnancy and CLP risk factors, including oral contraceptive (OC), absence of vitamin supplementation, smoking, and alcohol use within the first eight-week of gestation period. Family history and maternal age were also assesed. Result : The rates of late pregnancy awareness were 10-folds higher in cases, with the scale of 65% compared to 6.5% (p value <0.0001). The use of OC in cases group were 22.6-folds higher (13.6% versus 0.6%), the absence of vitamin supplementation were found to be 123-folds higher as well (73.8% compared to 0.6%). An inverted data were found in the smoke exposure parameter, which was higher in control (27.7% versus 10.7%). In confounded factors, advanced maternal age in the cases soared (37.9% compared to 25.3%), positive family history of cleft were discovered in 24.3% of mother with cleft children. Conclusion : Most cases were categorized in late pregnancy awareness. Higher rates of positive family history and advanced maternal age in cases group were also found.

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