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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.

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Articles 250 Documents

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Effectiveness Of Early Excisional Debridement In Burn Injuries To Sepsis Incidence And Mortality Rate At Burn Unit Of Hasan Sadikin Hospital Bowo, Setiagung Ambari; Soedjana, Hardisiswo
Jurnal Plastik Rekonstruksi Vol. 3 No. 2 (2016): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Sepsis is an important cause of mortality in patients with burn, although many factors influence it. Early excision debridement as source control treatment has been done routinely in our center. It was intended to prevent sepsis and decrease mortality rate. Methods: We performed a retrospective, cross sectional study over 4 years (2012-2014) among patients with flame burns in Burn Unit Dr. Hasan Sadikin Hospital who underwent early excisional debridement. The criteria of patients were adult, with full thickness burn, without inhalation injury and co morbid disease. The mortality, length of stay, and incidence of sepsis were analyzed by simple regression linier statistics using SPSS 16.0 for Windows. Results: Mortality rate of all patients was 43.3%, and 42.3% was directly caused by sepsis. Thirty-nine patients matched the criteria, 20 patients had early excision (< 3 days) and 19 patients had late excision (> 3 days). In early excision group, 75% got sepsis and 55% died. Mortality and incidence of sepsis wasn’t significantly different in both groups (p=0.252 and p=0.855). Both groups have same length of stay (mean : 13.1 and p=0.236). Sex as confounding factor wasn’t significantly different (p=0.774). The extent of TBSA and age were significant factors causing mortality rate (p < 0.05). Conclusion: There are many factors that contribute to the success of treating burn patient. Excision debridement was proven by this study not a major factor and ineffective to decrease sepsis and mortality in burned patients.

Honey As A Treatment For Diabetic Foot Ulcer: A Systematic Review Insani, Ide Bagoes; Widayanti, Nurina; Rifki, Aliyya
Jurnal Plastik Rekonstruksi Vol. 3 No. 2 (2016): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background : Increased number of antibiotic-resistance bacteria has made honey widely reused as a modern wound treatment, including for Diabetic Foot Ulcer (DFU) treatment. Researchers have studied mean duration of wound healing and effectivity of honey dressing compared to other substances, such as povidone iodine, normal saline or alginate. This systematic review was conducted to objectively evaluate mean duration of wound healing using topical honey dressing compared to other substances in the treatment of DFU. Method : All RCT and CCT trials were collected from 4 electronic databases using keywords “Honey”, “Honey dressing”, “Diabetic foot ulcer”, and “Diabetic ulcer”. We included all English literatures with year of publication from January 2006 to November 2016; studies comparing honey with other substances; and patients with DFUs. Qualitative assessment of these studies were scored using Jadad Scale. Result : A total of 5 studies involving 517 participants were included. None of 5 studies obtained full Jadad score in quality assessment due to lack of description on randomization method, blinding and dropouts. Three studies reported significantly shorter mean duration of wound healing in honey dressing compared to normal saline and alginate dressing. Other 2 studies reported insignificant difference compared to povidone iodine, although honey still has shorter mean duration of wound healing. Two studies reported less pain during dressing changes in honey dressing group. Conclusion : Honey dressing was superior than control group (normal saline, alginate, and povidone iodine) in reducing mean duration of wound healing in DFU patients. It was also proven to cause less pain during dressing changes. Due to high heterogeneity we are unable to carry out a meta-analysis.

Antropometric Evaluation Of Gentur's Cheiloplasty Method In Unilateral Cleft Lip Septrina, Rani; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 3 No. 2 (2016): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Cheiloplasty, the earliest surgical procedure in cleft lip and palate patient, has impact on functional and aesthetical appearance1. The Gentur’s technique is a method of cleft lip surgery that has been developed by him and has been used in RSUPN Cipto Mangunkusumo/Faculty of Medicine Universitas Indonesia2. It uses the rotation-advancement, small triangular, preventing notching concepts with some other details to overcome the wide cleft. This study was conducted to answer whether the Gentur’s technique gives symmetrical result in anthropometric measurements. Methods: Cross sectional analytic study will be taken from medical record in 14 unilateral cleft lip patients underwent cheiloplasty procedure. Direct anthropometric data before and after procedure were analyzed using SPSS17. Anthropometric data such as cupid’s bow, vertical height, horizontal height, vermillion and nostril were noted. Results: From 14 patients, we found 9 patients who underwent surgery in 3 months of age (64.3%) are mostly female (n=9, 64.3%), have complete defect (n=12, 85.8%) and left sided defect (n=8, 57.1%). Gentur’s technique is able to produce significant lip and nose symmetry (CI 95%, pvalue <0.005) in cupid’s bow, vertical height, horizontal height, thickness of vermillion and nose. By doing this technique, the author is able to create good lip and nose symmetry (78.57%) even in wide defect (64.3%) and palatal collapse (57.1%). Conclusion: Gentur’s technique is able to utilize tissue deficiency to create ideal lip and nose in unilateral cleft lip repair even in patients with wide gap.

Rare Expression Of Van Der Wound Syndrome: A Case Report Revisited Bangun, Kristaninta; Widayanti, Nurina; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 3 No. 2 (2016): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Van der Woude syndrome (VWS) is a rare developmental malformation, characterized by pits in the lower lip. Van der Woude syndrome is an autosomal dominant craniofacial syndrome with various expression: lower lip pits, cleft lip with or without cleft palate, syngnathia, hypoodontia, and ankyloglossia. Extra-oral abnormalities findings can be found: syndactily, corpus callosum dysgenesis, megacolon, ventricular septal defect and genital abnormality. Methods: We reported a case of 5-month-old male with rare expression of VWS: bilateral cleft lip and palate, syngnathia, lower lip pits, ptosis of upper left eyelid and macropenis. Results: We perform surgery to release the fibrous band to achieve satisfactory maximum mouth opening. Next we perform cheiloplasty and lower lip pit removal. Conclusion: Proper surgical intervention in VWS patients can improve feeding and prevent further temporomandibular complications. Careful examination of patients with cleft lip and lower lip pit should be done to avoid misdiagnosis.

Application Of Allo Mesenchymal Stem Cells On Chronic Burn Wound: Case Series Report Wardhana, Aditya; Liem, Isabella Kurnia; Feroniasanti, Lauda; Pudjiti, Dyah Juliana; Mujadid, Fajar; Kispa, Tera; Novialdi, Novialdi
Jurnal Plastik Rekonstruksi Vol. 4 No. 1 (2017): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background : Severe burns are among the commonly occurring trauma with lethal outcome. One of the important aspects of severe burn therapy is to quickly achieve wound healing. Previous reports indicated that mesenchymal stem cells (MSCs) therapy contributes in facilitating better wound healing. In this report, we investigated the effects of MSCs derived from human bone marrow and umbilical cord on wound healing in patients with severe burns and its mechanism. Method : We performed human bone marrow and human umbilical cord MSCs therapy on 3 severe burns patients. Two of the patients had inadequate donor to close raw surface with skin graft, whilst one patient had infected chronic burn wound which have failed to epithelialize despite repeated attempts of skin graft and wound care. Result : We observed that MSCs therapy significantly accelerated wound healing. The effects after MSCs migrated into wound were decreased infiltration of inflammatory cells and faster epithelialization. Conclusion : This study suggests that MSCs therapy has positive effects in improving wound healing in severe burns patients. Data provided by this research may serve as theoretical basis for further study of MSCs application in burn wound therapy.

Surgery and Rehabilitation Following Flexor Tendon Zone II Injury Of The Hand: A Literature Review Lumintang, Loelita Marcelia; Nata’atmadja, Beta Subakti
Jurnal Plastik Rekonstruksi Vol. 4 No. 1 (2017): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background : Flexor tendon injury of the hand is common and it used to end up with poor outcomes. It gives negative effects to patient’s daily life. Successful treatment for these cases is a challenge for surgeons. Before 1967, Injury in Zone II was called as “No Man’s Land”. Flexor tendon repair and rehabilitation have been substantially improved through advances in repair and rehabilitation. Method : We reviewed literatures from PubMed, MEDLINE, Cochrane and Google Scholar. It was researched using the terms flexor tendon zone II injury, flexor tendon zone II repair and flexor tendon zone II rehabilitation. Topics covered included anatomy, suture repair and material, and rehabilitation. Result : There is no significant difference of rupture rates and functional outcomes in the number of core suture. Braided polyester suture is the choice for core suture and monofilament for peripheral suture. There is no significant difference in rehabilitation using early passive motion or early active motion. The preference for post operative treatment is by using short splint without immobilization of the wrist. Discussion : Repair sutures techniques and suture materials have been improved as well as active mobilization rehabilitation protocols including a change of wrist position by modification of splints. Improvement in putting splint from a traditional dorsal blocking splint into splint that not immobilize the wrist. Despite all of these modifications, tendon ruptures have not been eliminated. The definitive answer remains elusive.

Tetrapod Fracture: Surgical Anatomy Revisited As A Guide For 3D Reduction Using Carroll Girard T-Bar Screw Kreshanti, Prasetyanugraheni; Gianni, Livia Faranita
Jurnal Plastik Rekonstruksi Vol. 4 No. 1 (2017): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Zygomaticomaxillary complex plays a key role in the structure, function, and aesthetic appearance of the facial skeleton. Using Carroll Girard T-bar screw allows easy manipulation of the zygomaticomaxillary complex fracture. The goal of the treatment is three dimensional (3-D) restoration of the disturbed anatomy. Methods: After exposing the fracture sites using technique such as lower eyelid, Dingman (lateral brow) or maxillary vestibular approach, the Carroll Girard T-bar screw is then attached to the lateral aspect of the malar eminence to freely move the zygoma according to the x,y, and z axis. Zygomaticosphenoid suture acts as the anatomical landmark for adequate reduction. Conclusion: Open reduction and internal fixation is the principle of management in displaced ZMC fractures, aided by the use of Carroll Girard T-bar screw which allows easy manipulation and rotation for the zygomatic bone using the reference axis x, y and z.

Parental Age As a Risk Factor Of Children With Cleft Lip In Jakarta Population: Does Paternal Age Play A Role? Widayanti, Nurina; Sudjatmiko, Gentur; Putri, Nandita Melati
Jurnal Plastik Rekonstruksi Vol. 4 No. 1 (2017): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Cleft lip and palate (CL/P) is one of the most common congenital anomalies with the prevalence of 1 case for every 1000 birth. The purpose of this study is to evaluate the association between paternal and maternal age to the incidence of cleft lip with or without cleft palate. Methods: This case-control study compares data of 74 cleft lip patients who was enrolled in Gentur Cleft Foundation Foundation year 2013 to 2015 compared to those of 86 normal children. Paternal and maternal age were categorized and compared to reference age (25-29 years old). Binary logistic regression was used to assess the interaction between paternal and maternal age adjusted to several confounding factors. Results: Paternal age (PA) 18-24 year has OR 9.12 (95% CI = 2.2-36.7), PA 30-34 has OR 2.74 (95% CI =1.2-5.9), PA 35-48 has OR 5.82 (95% CI = 2.2-15.67) compared to those in the 25-29 years category. Maternal age (MA) 18-24 year has OR 4.385 (95% CI = 1.86-10.36), MA 35-48 has OR 6.58 (95% CI = 1.65-26.31) compared to those in the 25-29 years category. P-value was insignificant for MA 30-34 years. Interaction were observed in crossings between PA 18-24 with MA 18-24, PA 25-29 with MA 18-24, PA 30-34 with MA 18-24, PA 30-34 with MA 25-29, PA 35-48 with MA 30-34, and PA 35-48 with MA 35-40. Conclusion: We observed stronger association between paternal ages with CL/P compared to that of maternal age. Interactions of paternal and maternal age with high OR were found in youngest age group (18-24 years old), oldest age group (above 35 years old), and fathers who are approximately 10 years older than the mother.

Lip Symmetry Evaluation Of The Gentur's Method Compared To Fisher Techniques For Unilateral Cleft Lip Repair Kreshanti, Prasetyanugraheni; Kiat, Muhammad Irsyad
Jurnal Plastik Rekonstruksi Vol. 4 No. 1 (2017): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background : Cleft lip and palate are the most common congenital anomalies that were found in plastic surgery. There are so many techniques for unilateral cleft lip repair. Rotation-advancement method by Gentur based on Millard technique has become the most widely used in unilateral cleft lip repair in RSCM. The Fisher technique repair is a modified technique based on approximation of anatomical subunit of the lip. The purpose of this study is to objectively compare and evaluate the lip symmetry of these two techniques. Method : Two senior board-certified plastic surgeons will perform different surgical techniques for the unilateral cleft lip: rotation-advancement technique by Gentur and Fisher technique. This study prospectively analyzed preoperative and postoperative of randomized single blinded patients who underwent unilateral cleft lip repair performed by each surgeon in 2016. Using caliper, facial points on the cleft and non-cleft sides were measured, including height and symmetry of Cupid’s bow, width and height of the nasal vestibule, height of the vermilion, and alar base position. Ratios of cleft side to non cleft side measurements were calculated to standardize comparisons between patients. Result : From July-October 2016, 14 patients performed surgery as preliminary data, showed that there are statistically difference in length of design and surgery time. Preoperative, comparable of cupid’s bow and vermillion showed statistically difference. Although, we found no statistically difference in postoperative ratio. Conclusion : Lip symmetry outcomes after cheiloplasty procedure are same between Gentur method and Fisher technique.

Use Of Synthetic Skin Substitute (Biobrane) For Plantar Foot Burn F, Johandi; J, Feng; Lumbun, Ruth; J, Chong; K, Tan B; C, Tan K
Jurnal Plastik Rekonstruksi Vol. 4 No. 2 (2017): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Background : In Singapore, we experience a unique annual surge of burn cases involving sole of foot during the Hindu fire walking festival. Traditionally, superficial partial-thickness burns of the soles were managed expectantly with regular dressings. We conducted a study to evaluate the effectiveness of an alternative approach of using synthetic skin substitute (Biobrane®). Method : A case series of foot burns admitted October 2016 to the Singapore General Hospital Burns Centre. Burn cases with superficial partial-thickness burn of bilateral sole of foot were included in the study. Exclusion criteria included deep dermal burns and burns that required excision and closure with skin grafting. The patient demographics, time to presentation, medical co-morbidities were analyzed. Outcomes such as length of hospital stay, incidence of infection, need for further surgery, return to pre-injury ambulation status and occupation and cost were studied. Result : A total of 6 partial thickness burns of sole of foot in 3 patients with bilateral foot burns which were treated with Biobrane® were included in the study. Patients were able to return pre-injury functional status- return to work and pre-morbid ambulation status. Neither incidence of wound infections nor any needs for repeat surgery were recorded. However, this group required an increased length of stay and incurred high treatment cost. Conclusion: Biobrane® is a viable adjunct in the management of sole of foot burns. The authors believe there is potential for an improved rate of recovery with Biobrane®. However, the higher cost and length of stay are among its drawbacks. In view of the limitations of our study- case series and small sample size, a prospective and double arm assessment will be required to present definite evidence for synthetic skin substitute in these cases

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