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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,

Civil Engineering, Building, Construction & Architecture Other

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.

Arjuna Subject : -

Articles 250 Documents

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How I Do It : Bilateral Cleft Lip Repair Sudjatmiko, Gentur; Pribadi, Sweety
Jurnal Plastik Rekonstruksi Vol. 2 No. 2 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Several techniques have evolved to achieve better outcomes in bilateral cleft lip repair. The techniques performed should overcome the challenge presented in bilateral cleft lip, such as protrusion of premaxilla, the short columella, the wide gap, minimal dry mucosa in prolabium also the low socioeconomic level that typically presented in cleft patient. Considering the challenges mentioned above, a proper design and precise technique should be defined. We proposed a design and technique with promising results, which involves: 1) The precision of the design, the adjustable point of the design to modify lateral flap will provide adequate thickness of vermillion to create tubercle as well as to provide adequate tissue for nasal floor. 2) The possibility to approximate the orbicularis oris muscle although the premaxilla is protruded. It is beneficial and cost-effective for the patients who cannot afford preoperative orthodontic treatment. 3) The suggestion to not worry about the immediate postoperative result as it will evolve to a satisfactory result. 4) The use of non-absorbable nylon 5.0 and 6.0 for the whole layers will overcome tension and reduce cost.

Bullet Penetration In The Face Caused By Accidental Gunshot: A Case Report Sastrasupena, Aditya Herwandar; Bangun, Kristaninta
Jurnal Plastik Rekonstruksi Vol. 2 No. 2 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Clinical and radiological examinations are used to predict the location of the bullet in bullet penetration injury. The maxillofacial region had a variety of structure which could make the bullet deviate from its normal trajectories. Patient and Methods: A rare case of bullet penetration in the face caused by accidental gunshot is described. A 32 year-old male was hit by a bullet in the face with entrance wound on the left temporal region. Radiologic examination showed a bullet in the left inferior orbita. Treatment was exploration and extraction of the bullet. In this case we observe the difference between the clinical examination, radiological diagnosis and intraoperative findings Result: The patient underwent an explorative operation based on the prediction of location of the bullet from the clinical and radiological examination. The bullet was found in the inferior rectus muscle which the location is out of the prediction of clinical examination and radiologic findings. Summary: Clinical and radiological examination do not always give the accurate prediction regarding the location of bullet in penetrating bullet injury of the face because the face has a variety of bone, muscle and soft tissue structure.

Mortality Analysis of Adult Burn Patients Martina, Nungki Ratna; Wardhana, Aditya
Jurnal Plastik Rekonstruksi Vol. 2 No. 2 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Backgrounds: Among burn patient, adult patient in productive age took a large number in statistic. Fire related to domestic accident and in workplace are the main source of burn incidences. A careful review of burn mortality of adult patient in Burn Unit of Ciptomangunkusumo Hospital is presented in this paper. The aim is to make a critical analysis of mortality in our burn centre with a view to finding possible ways of improving the care given to our patients and suggesting ways of reducing mortality. Patients and Method: A descriptive analysis study was done to analyze data collected by the review of medical records of the patients hospitalized to our Burn Center for burn injury from Januari 2011– Desember 2012. Parameters investigated include patients’ demographics, data for etiology and extent of burn injury, cause of death and the mortality were tabulated, computerized and analyzed. Result: During this 2-year period, 275 patients were admitted, 203 patients were adults. Number of death in adult patient were 76 patients (27,6%). Among the died patients, seventy-eight percent caused by flame, electrical burn injury (14%), hot water (4%), chemical (3%), metal (1%). Almost all burn extent was deep dermal (2nd degree) and full thickness (3rd degree). The cause of death including septicaemia (42,1%), multiple organ failure (31,6%), systemic inflammatory response syndrome (17,6%), and acute respiratory distress syndrome (8,7%). Conclusion: In order to implement a successful burn injury prevention program, it is important to focus on selected issues. A few specific recommendations can be suggested based on these epidemiological features. Our ongoing efforts are to promote and support prevention program and look for changes in the incidence of burn injury.

Dressing for Partial Thickness Burn Using Microbial Cellulose and Transparent Film Dressing : A Comparative Study Djaprie, Shelly M; Wardhana, Aditya
Jurnal Plastik Rekonstruksi Vol. 2 No. 2 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Wound dressing aims are to create moist and warm condition to accelerate wound healing, decrease level of pain, collects of exudate, decrease the need of dressing changes, cost effectiveness and protection from bacterial contamination. Microbial cellulose creates a moist environment and strong adhesion to the wound to prevent bacterial contamination and protects from temperature changes. Meanwhile transparent film dressing has advantages such as easy to evaluate, rapid rate of epithelialization and provides high comfort for patients. This study aims to evaluate the efficacy of microbial cellulose dressing compare to transparent film dressing as control, in the treatment of partial thickness burn. Method: We perform a single blind randomized clinical trial study. All patients with partial thickness burn with total body surface less than 20% area burns at any age presenting to our burn unit will be included in the study. They were dressed using microbial cellulose and transparent film as control. Result: The epithelialization rate of patients treated by microbial cellulose was significantly faster and less pain, especially in day 3 and 10 (p=0,000) than those treated with transparent dressing. This study showed patient using microbial cellulose no need to change dressing, meanwhile in transparent dressing it need 2 to 3 times dressing changes and costs more money. Conclusion: The use of microbial cellulose dressing is a versatile and effective dressing for partial thickness burns. This innovative material will be an alternative dressing in partial-thickness burn wounds.

Vein-Supercharged Peroneal Artery Perforator Propeller Flap for Achilles Soft Tissue Coverage Atmodiwirjo, Parintosa; Supit, Laureen
Jurnal Plastik Rekonstruksi Vol. 2 No. 2 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Wounds on the distal third of the lower extremity are reconstructively challenging, as there is lack of spare local tissue to design local flaps from. The perceived alternative is to perform free flaps to cover for these defects. Drawbacks include the need for specific training to perform microsurgery, longer time required, and the probable bulkiness when donor is obtained from certain areas. The perforator propeller flap is a local island fasciocutaneous flap, designed with 2 blades of skin island of unequal length extending from each side of the perforator. As the flap is rotated, the longer blade will cover the defect. Patient and Method: A case of soft tissue defect on the achilles is reported, with successful defect closure by utilizing a peronal artery perforator based fasciocutaneous propeller flap with 180 degree rotation and vein supercharge to facilitate backflow. Secondary defect required split-thickness skin grafting. Result: After surgery, muscles of the lower limb started to swell and get compromised. We removed some stitches to allow soft tissue expansion underneath the flap. after the release, flap perfusion improved. Stitches were left open for 3 days, then closure of flap edges by placing gradual traction sutures which were tightened daily. By the 7th day, flap edges was re-approximated and the skin grafts took well. Summary: The ability of the propeller flap to rotate makes this flap highly useful and versatile for the reconstruction of distal lower limb defects. Flap dimension can be enhanced when distal part of the flap is supercharged to neighboring recipient vessels. Another advantage is the close vicinity of donor, giving better aesthetic result.6

Random Perforator Flap : Some Experiences with Keystone Flap Sudjatmiko, Gentur; Pribadi, Sweety; Supit, Laureen
Jurnal Plastik Rekonstruksi Vol. 2 No. 2 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: In reconstructing challenging defects, surgeons are considered fairly fortunate when they are able to obtain a similar donor tissue quality to that of the missing tissue; in regards to their color, texture, size, and the ease of donor transfer to the defect. Several methods may be used, which frequently include the free tissue transfers using microvascular anastomoses bearing their specific consequences. We report a select of challenging cases which were successfully reconstructed using the Keystone flaps and avoid microvascular anastomoses, where otherwise the free tissue transfers would be the typical option for closure in such defects. Patient and Method: Nine cases of relatively large defect in various locations were reconstructed using the Keystone flaps supplied by either non-identified perforators or identified reliable perforators. Result: Out of the 9 defects located on various region of the body (lumbar, thorax, dorsum of the foot, plantar of the foot, posterior leg, sacrum, and cervicofacial) only the first 2 cases had identifiable perforators. All flaps survived completely without problem of vascularization. Summary: The Keystone flap is a useful and reliable random perforator-based flap even when the perforator vessels are not identified.

Sole Reconstruction Using Anterolateral Thigh Free Flap: A Review of 4 Cases Atmodiwirjo, Parintosa; Sandhi, Afriyanti
Jurnal Plastik Rekonstruksi Vol. 2 No. 3 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: The ideal technique for sole reconstruction should meet such requisite as a durable and comfortable weight-bearing surface, solid anchoring to deep tissue for resistance to shear force and adequate protective sensation. The anterolateral thigh (ALT) perforator free flap provides a large, pliable skin island and sufficient bulk, allowing three-dimensional tailoring to complex defects. The present article is about our experience of sole reconstruction ALT perforator free flap. Patient and Method: Total of 4 flaps in the foot defects was performed in February 2009 to December 2012. We reconstructed soft tissue defects in the sole using ALT free flaps, the complications, aesthetic and function results were monitored. Result: ALT perforator free flap provided stable and durable long-term wound cover in all patients, resulting in early rehabilitation and function outcomes were completely achieved. Complications were few and manageable in all cases. Summary: ALT perforator free flap has become common procedure in many centers around the world. The numerous advantages include stable wound coverage; improve aesthetic and functional outcomes, and minimal donor site morbidity. In our experiences, we found that the use of ALT perforator free flap in sole defect reconstruction, to be technically affordable, reliable and have resulted in excellent outcomes.

Long Term Follow Up of Hemangioma on Bilateral Cleft Lip Atmodiwirjo, Parintosa; Lestari, Puri Ambar; Kesuma, Ayu Diah
Jurnal Plastik Rekonstruksi Vol. 2 No. 3 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Hemangioma is a common tumor of infancy that exhibits rapid postnatal growth and slow regression during childhood. Cleft lip is a common anomaly found in Indonesia. These entities are twice in common in the Asian population. However, simultaneous occurance of these two abnormalities is rare to be found. Patient and Method: A case of bilateral cleft lip complicated with hemangioma on the left side of lip and the surrounding skin through the mucosa, and the prolabium, which had been performed cheiloplasty procedure at age 9 months old. Cheiloplasty design was made through the hemangioma area with a careful hemostasis to avoid massive bleeding. Result: Hemangioma was partially left behind at the cheiloplasty procedure. There was no bleeding during and after the surgery. Two years following the surgery, there was a fine scar with good shape of the lip and no further growth of the hemangioma. Summary: Hemangioma and cleft lip are very rare to be found in the same location. Because of the involution potential of hemangioma, timing of surgery is very important. Considering the psychosocial aspect, the surgery was performed at the age of 9 months. Two years after surgery, we didn’t find any growth of hemangioma or deformity of the bone and lip. The scar growth is in good esthetic result, no difference with left lip child without hemangioma.

Reconstructive Rhinoplasty: New Technique of Central Cartilaginous Support Sajid, Muhammad; Bhatti, Zahid; Nazeer, Aisha; Mughese, Sadia; Tayyaba, Tayyaba; Amin, Mohammad Mughese
Jurnal Plastik Rekonstruksi Vol. 2 No. 3 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Honour amputation is a common cause of nose amputation in Pakistan, especially in dahawalpur region. Skeletal support is always a problem in major nasal amputations. It needs multiple delays and extra support later on, with all traditional techniques. Patient and Method: We reported three cases of amputation of the nose. We used sliding septal technique to reconstruct the central cartilaginous support of the nose. In this technique we used the remaining septum as a free graft. Ten patients were treated with this technique with excellent results. Nasal lining was provided either with septal artery mucosal flap or with nasolabial flap. Forehead flap was the only flap to provide external cover. Nostril rim were grafted with trimmed choncial cartilage primarily. In three patients debulking procedures were done later on , but no skeletal procedures. Result: This technique has given an excellent skeletal support and a nice tip projection with no delays or extra support later on. Patient satisfaction rate was 100%. Summary: Sliding septal technique is a very reliables, cost effective technique. It provides an excellent tip support in a single procedure, without sacrificing other precious material like rib or bone.

Frontal Suspension Procedure using Frontalis Muscle for Management of Ptosis Soedjana, Hardisiswo
Jurnal Plastik Rekonstruksi Vol. 2 No. 3 (2013): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background : Ptosis has a reputation as a cosmetic problem, but it is more often as a functional deficit that can have real impact on patients’ lives. Ptosis results from the dysfunction of one or both of the upper eyelid retractors and often blocks peripheral vision. Ptosis can be congenital or caused by aging. Frontal suspension is one of few techniques for correction of ptosis especially for severe ptosis. Patient and Method : We reported one case of severe ptosis. The patient had bilateral congenital ptosis at both of upper eyelids. The upperlid excursion was 4 mm and marginal reflex distance (MRD) was 2 mm. A frontal suspension procedure using frontalis muscle was done for correction. Result : After frontal suspension procedure, MRDare 5 mm for both eyes. There wee no difficulty for closing the eyes. The cosmetic appearance was good. Patient was satisfied with the result. Conclusion : Frontal suspension procedure using frontalis muscle gives a good function and cosmetic result for severe ptosis.

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