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INDONESIA
Jurnal Plastik Rekonstruksi
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 260 Documents
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Comparison of Hospital Stay of Burn Patients Undergoing Early Tangential Excision and Delayed Tangential Excision in The Burn Unit of Cipto Mangunkusumo Hospital in 2023 - 2024 Aditya Wardhana; Fezza Uktolseja
Jurnal Plastik Rekonstruksi Vol. 13 No. 2 (2026): (2026) 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.v13i2.39

Abstract

Background: Burns remain a major challenge in plastic surgery due to their high mortality and morbidity. Tangential excision, a surgical procedure to remove necrotic tissue while preserving viable tissue, should be performed as soon as possible, as it has been shown to decrease hospital stay in burns ≤30% TBSA. While early excision has shown benefits in smaller burns, evidence is lacking for larger burns and in resource-limited settings such as Indonesia. This study compared hospital stays among burn patients who underwent early versus delayed tangential excision.Methods: This retrospective cohort study included burn patients who were discharged alive and underwent early or delayed tangential excision between January 2023 and December 2024. We divided subjects into two groups: early excision and delayed excision. We analysed data using the Mann-Whitney test to assess differences in hospital stay between the two groups.Results: This study included 100 patients: 63 who underwent early tangential excision and 37 who underwent delayed tangential excision. The median TBSA was 29.5% (range 10–71%). The median length of hospitalisation was lower in the early excision group than in the delayed excision group, although not statistically significant (20 [5–49] vs 20 [7–66]; p=0.274).Conclusion: Although no statistically significant difference was observed, the trend toward shorter hospital stay in the early excision group provides important preliminary evidence to guide national burn protocols.
Effectiveness of Tumescent in Reducing Blood Loss in Tangential Excision for Adult Burn Patients: A Systematic Review Aditya Wardhana; Albireza Ruhimat
Jurnal Plastik Rekonstruksi Vol. 13 No. 1 (2026): (2026) 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.v13i1.43

Abstract

Introduction: T Tangential excision is a standard surgical approach for managing deep burns, yet it often results in considerable intraoperative blood loss. This can lead to increased transfusion needs and a higher risk of postoperative complications. Among the strategies developed to minimize bleeding, tumescent infiltration—using diluted vasoconstrictors such as epinephrine—has gained interest due to its affordability, simplicity, and applicability in resource-limited settings.Method: This systematic review followed PRISMA 2020 guidelines. Literature searches were conducted in CENTRAL, MEDLINE (via PubMed), Scopus, and EBSCOhost. Included studies comprised randomized controlled trials, cohort studies, and case series assessing the impact of tumescent infiltration on intraoperative blood loss in adult patients undergoing tangential excision. Extracted data included study design, patient demographics, burn characteristics, surgical techniques, and outcomes related to blood loss and transfusion. Risk of bias was assessed using RoB 2.0 and ROBINS-I tools.Results: Seven studies were included for qualitative synthesis, most of which were cohort designs involving patients with full-thickness burns covering 1–50% of Total Body Surface Area (TBSA). The use of tumescent infiltration—commonly employing epinephrine concentration between 1:500.000 until 1:2.000.000 dilution—consistently demonstrated reduced intraoperative blood loss compared to conventional techniques such as adrenaline-soaked gauze. The degree of blood loss reduction varied across studies, influenced by TBSA, unit used, surgical methods, and infiltration protocols.Conclusion: Tumescent infiltration using epinephrine is an effective and safe method for reducing intraoperative bleeding in adult burn patients undergoing tangential excision even though there are differences in measurement of bleeding and tumescent concentration. Further multicenter cohort studies with standardized blood loss measurements are needed to confirm these findings and support wider adoption.
Beyond The Standard: Achieving Functional and Aesthetic Excellence in Unilateral Macrostomia Repair with Buccal Flap and Multi Z-Plasty Technique in Infancy Bimayudo Aprialdi; Affandi Wiramur; Rafeni Bunga Cikita
Jurnal Plastik Rekonstruksi Vol. 13 No. 1 (2026): (2026) 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.v13i1.52

Abstract

Introduction: Macrostomia is a rare congenital craniofacial anomaly that significantly affects feeding, speech, aesthetics, and psychosocial well-being. Early surgical intervention using advanced techniques is essential to restore anatomical integrity and improve functional outcomes. This case report presents the management of a five-month-old female infant with a unilateral left-sided macrostomia (Tessier Cleft-7) using a combination of buccal flap and multiple Z-plasty techniques.Case Presentation: The patient presented with a unilateral left-sided macrostomia since birth, accompanied by feeding difficulties characterized by choking and audible “blup-blup” sounds during feeding. Physical examination confirmed a moderate unilateral macrostomia without signs of infection or systemic illness. Preoperative assessments, including laboratory tests and multidisciplinary consultations, confirmed the patient’s fitness for surgery.Discussion: Surgical repair was performed with a multi-layer closure approach, utilizing a buccal flap for the inner layer and multiple Z-plasty for the outer layer to achieve tension-free closure and optimal aesthetic results. This technique aligns with contemporary trends favoring individualized, anatomy-driven repairs over traditional methods. The absence of intraoperative and postoperative complications and the satisfactory functional and cosmetic outcomes underscore the effectiveness of this approach. Compared to conventional linear closure techniques, multiple Z-plasty minimize scar contracture and enhance commissural symmetry, particularly in complex cases of macrostomia. This case highlights the critical role of multidisciplinary collaboration and tailored surgical planning in addressing the anatomical challenges of macrostomia and achieving optimal reconstructive outcomes.Conclusion: Early, multidisciplinary management of macrostomia using combined buccal flap and multiple Z-plasty techniques can achieve excellent functional and aesthetic outcomes with minimal complications. This case contributes to the growing literature supporting anatomy-specific surgical approaches and comprehensive perioperative care in macrostomia reconstruction.
Fisher’s and Modified Millard-Onizuka Techniques for Unilateral Cleft Lip Repair: Comparison of Surgical Outcomes and Patient Satisfaction Kristaninta Bangun; Andi Azwadi Rais; Vika Tania; Puri Ambar Lestari; Dhita Kurniasari; Vania Aramita Sari; Clara Menna
Jurnal Plastik Rekonstruksi Vol. 13 No. 1 (2026): (2026) 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.v13i1.55

Abstract

Introduction: Unilateral cleft lip (UCL) surgery aims to achieve symmetry and correct functional and aesthetic issues. The Millard technique dominated until 2005, when Fisher introduced a new surgical method that is still in use today. This study aims to compare the symmetry outcomes and patient satisfaction levels between the Fisher and Modified Millard-Onizuka techniques.Method : A retrospective cohort study was conducted to compare the outcomes of the Fisher and Modified Millard-Onizuka techniques in patients with UCL who had undergone cleft lip surgery. Five experienced plastic surgeons assessed photographs using Steffensen’s criteria, while patients and parents completed the Cleft Evaluation Profile satisfaction questionnaire. Data were analysed using SPSS v.29.Results: The intraclass correlation test showed a Cronbach’s alpha >0.7 for all criteria, indicating strong reliability. Statistical analysis revealed no significant differences in Steffensen's criteria scores among the five raters between the study groups. However, the satisfaction questionnaire indicated higher satisfaction with dental appearance in the Fisher technique group. This finding may be attributed to the fact that all patients in this group were treated at a multidisciplinary cleft centre.Conclusion: Surgical outcomes and patient satisfaction after cleft lip surgery using Fisher’s technique are comparable to the modified Millard-Onizuka technique.
Adult Burn Contracture Reconstructions Caused by Burn Injury During Childhood: Patients’ Quality of Life and Surgical Challenges I Nyoman Putu Riasa; Bertha Kawilarang
Jurnal Plastik Rekonstruksi Vol. 13 No. 1 (2026): (2026) 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.v13i1.59

Abstract

Introduction: In many low- and middle-income countries (LMICs), childhood burns continue to be common, and contractures that persist into adulthood lead to significant disability. Observational studies suggest that health-related quality of life (HRQoL) generally improves over time in adult burn survivors; however, individuals with burn-scar contractures experience greater disability and lower HRQoL.Method: Descriptive, single-centre case series. Four adults with longstanding contractures from childhood flame burns were identified: postoperative qualitative HRQoL data (unstructured interviews). Surgical techniques and outcomes were recorded from clinical notes and photographs.Results: Growth through the scar caused multilevel deformities (bone/joint, tendon, soft tissue). Staged surgery included: (i) wrist/hand contracture release with ligament stabilisation, K-wire fixation, and tendon lengthening; (ii) multistage auricular reconstruction using a costal-cartilage framework covered by a pedicled temporoparietal fascial flap (TPFF) and ultrathin scalp skin graft; (iii) trunk/inguinoperineal release with abdominoplasty-style umbilical and nipple-areola complex (NAC) repositioning, and pedicled latissimus dorsi myocutaneous (LD-MC) flap; and (iv) staged regional reconstruction following oncologic resection of squamous-cell carcinoma (SCC) arising in a burn scar. In all cases, daily function and psychosocial well-being improved, and patients returned to work, demonstrating strong motivation for staged procedures.Conclusion: Even when reconstruction is delayed until adulthood, focusing on high-impact functional goals in a staged plan produces meaningful HRQoL improvements for survivors of childhood flame burns in resource-constrained settings.
Auricular Reconstruction and Postoperative Wound Care in Necrotizing Fasciitis Secondary to Malignant Otitis Externa in a Diabetic Patient with Scabies Amira Azra Arisa Putri; Mufida Muzakkie; Ratna Maila Dewi Anggraini; Fadel Fikri Suharto
Jurnal Plastik Rekonstruksi Vol. 13 No. 1 (2026): (2026) 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.v13i1.63

Abstract

Introduction: Necrotizing fasciitis of the auricle and periauricular region is extremely rare but life-threatening, typically affecting immunocompromised patients and occasionally complicating malignant otitis externa. Its aggressive progression and the auricle's complex anatomy demand early diagnosis and prompt multidisciplinary management to prevent extensive tissue loss.Case presentation: We report auricular necrotizing fasciitis secondary to malignant otitis externa in a 55-year-old patient with poorly controlled diabetes mellitus and concomitant scabies infestation. The infection progressed rapidly, causing necrosis of the auricle and surrounding soft tissues. Culture identified Pseudomonas aeruginosa as the causative pathogen. Management included targeted systemic antibiotics, strict glycemic control, and early staged surgical debridement. The plastic surgery team performed selective staged debridement, removing non-viable tissue while maximally preserving viable auricular cartilage. Postoperative care employed honey-based dressings to control infection and promote granulation.Conclusion: This case demonstrates the synergistic effects of diabetes mellitus and scabies in predisposing patients to severe infections and impairing wound healing. An early plastic surgery consultation facilitated anatomically precise debridement, preservation of the auricular contour, and avoidance of radical excision. Auricular necrotising fasciitis remains a surgical emergency requiring timely multidisciplinary intervention and tailored wound management to optimise functional and aesthetic outcomes in high-risk patients.
Congenital Muscular Torticollis Treated with Unipolar Release: A Case Report Tan Margaretha Heidina Handoko; Gina Yunita Joice Sitorus
Jurnal Plastik Rekonstruksi Vol. 13 No. 2 (2026): (2026) 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.v13i2.38

Abstract

Introduction: CMT is a commonly found deformity of the neck that involves sternocleidomastoid muscle shortening that causes head tilt. Most cases respond well to early conservative treatment in infancy, but in cases of older patients mostly requires surgery. Data of CMT in older patients are not much, therefore, the optimal surgical treatment for these groups of patients is controversial.Method: This study was a retrospective case of a 9-year-old patient with CMT underwent unipolar release of the SCM done in 2023. Case report based on the medical and surgical records.Results: Four months following unipolar release of the SCM and post-surgery treatment using cervical collar, we noticed a lot of improvements of the patient’s neck range of motion and also the head tilt. Cosmetic result of the scar was also satisfactory. Conclusion: CMT is a frequent clinical condition but it is often underdiagnosed, and referred for evaluation at later stage. Early diagnosis and interventions are critical so that complete and rapid resolution may be achieved. However, if surgery is needed, unipolar tenotomy of the distal SCM may be a good option that gives good results in uncomplicated cases of CMT alongside adequate post-operative treatments including cast and physiotherapy.
Artificial Intelligence in Plastic and Hand Surgery – Potential or Provocation? Mohammed Misbahuddin-Leis; Elias Polykandriotis; Boris Radeleff; Zeki Ilhan; Muzaffer Ankolvi
Jurnal Plastik Rekonstruksi Vol. 13 No. 2 (2026): (2026) 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.v13i2.48

Abstract

Introduction: Surgical specialities like plastic and hand surgery, which depend on precision, aesthetic, and functional outcomes, are integrating AI, creating potential and challenges. AI is rapidly transforming clinical procedures, requiring evaluation of its potential to improve clinical care and the challenges it faces. This narrative review critically evaluates the clinical applications, emerging innovations, and ethical challenges of AI in plastic and hand surgery, synthesising evidence on both its transformative potential and the challenges it presents.Method: We conducted a narrative review of peer-reviewed literature using PubMed, Scopus, and Web of Science (2018-2025). Keywords included “artificial intelligence,” “machine learning,” “deep learning,” “plastic surgery,” “hand surgery,” “microsurgery,” and “convolutional neural networks.” We included studies on clinical applications, technological innovations, and ethical considerations. This review differs from existing syntheses by providing a balanced “Potential vs Provocation” framework that systematically addresses both benefits and challenges while proposing concrete implementation strategies for clinical practice.Results: AI technologies such as convolutional neural networks and large language models classify skin lesions, evaluate aesthetics, and automate operative documentation.Conclusion: Innovations such as generative AI, mixed reality, and predictive analytics in microsurgical procedures, patient-specific simulations, and smart rehabilitation have driven tremendous advances in this field. Despite this potential, significant challenges remain, including data bias, limited AI model interpretability, and concerns about liability and privacy. AI in plastic and hand surgery has significant potential to strengthen surgeons; however, integrating it requires acceptance, education, interdisciplinary collaboration, and ethical guidelines to address the challenges of this technological evolution.
Neglected Third-Degree Burn Wounds of The Lower Limbs: Full-Thickness Skin Graft Technical and Functional Considerations Tiffany Tiffany; Audrey Beatricia Suwandi; Qori Haly
Jurnal Plastik Rekonstruksi Vol. 13 No. 2 (2026): (2026) 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.v13i2.58

Abstract

This case report describes the reconstruction of neglected bilateral deep burns near the popliteal joints in a 50-year-old woman with severe restriction of knee extension. The burn area was estimated at 25% TBSA (22% partial-thickness; 3% full-thickness). Under general anaesthesia, eschar was excised to the fascia, and inguinal full-thickness skin grafts (FTSGs) were applied; donor sites were closed primarily. Therasorb and transparent dressings protected the grafts, and a back slab was used for two weeks. Inpatient cefotaxime and discharge cefadroxil were documented. Daily rehabilitation began after immobilisation. Complete clinical graft take was reported within two to three weeks, and knee extension improved qualitatively, without goniometric measurements. This case illustrates technical and functional considerations of FTSG adjacent to highly mobile joints.
Erectile Function Improvement Following Excision and Reconstruction for Penile Sclerosing Lipogranuloma: An Observational Study in Southeast Indonesia Arley Sadra Telussa; Robertus Arian Datusanantyo; Angela DJunaedi; James Soewardy
Jurnal Plastik Rekonstruksi Vol. 13 No. 2 (2026): (2026) 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.v13i2.62

Abstract

Introduction: Penile sclerosing lipogranuloma (PSL) is a chronic inflammatory condition caused by foreign material injection into the penis. Patients often present with pain, deformity, and impaired sexual function. Although operative intervention remains the cornerstone of PSL management, quantitative data on postoperative erectile function remain limited. This study evaluated changes in erectile function after surgery using a standardised scoring system.Method: This quantitative observational analytic study used a pretest-posttest design. Patients diagnosed with PSL who underwent operative intervention were included. We classified disease severity using Soebhali’s classification. Erectile function was measured pre- and postoperatively using the International Index of Erectile Function-5 (IIEF-5). We performed statistical analyses to assess changes in erectile function and their association with disease severity and operative technique.Results: We included 11 patients, with a mean age of 31.09 years. Most patients were sexually active and presented with Soebhali category 2 disease. Penile deformity was the main complaint. The mean interval from injection to presentation was 4.82 years. Operative intervention consisted of excision followed by primary closure in seven patients and one-stage bipedicled scrotal flap reconstruction in four patients. All patients showed improvement in the postoperative IIEF-5 scores, with statistical significance (p = 0.005). Improvement was not associated with initial disease severity or operative technique.Conclusion: Operative intervention of PSL leads to meaningful improvement in erectile function. The benefit appears to be related to effective lesion excision and restoration of penile tissue integrity rather than disease severity or reconstruction.

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