Garuda - Garba Rujukan Digital

Laidding, Sachraswaty

Yayasan Lingkar Studi Bedah Plastik

Author-ID : 1015969

Civil Engineering, Building, Construction & Architecture Other

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Articles

Reconstruction of Distal Phalangeal Injuries with Homodigital Island Flap: a Case Report Atmodiwirjo, Parintosa; Laidding, Sachraswaty
Jurnal Plastik Rekonstruksi Vol. 1 No. 4 (2012): July Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Reconstruction of distal phalangeal defects with exposure of bone, tendon, or joint can be a difficult reconstructive problem, particularly since immediate coverage is of paramount importance for preserving function. The objectives of distal phalangeal defect or fingertip reconstruction included preservation of functional length and sensibility, prevention of symptomatic neuromas, acceptable donor site morbidity, the absence of cold intolerance, mineralization of aesthetic deformity, and quick return to occupational activities.Patients and Method: A review of one case, 26 years old male with phalangeal defect at tip to radial site of 3th finger of right hand, with tendon and bone exposed. After adequate debridement, shape and size of the defect are measured, the flap designed at the ulnar site of the same finger and the vascular of the flap is marked to palmar arch. Lazy “S” incision performed, donor flap is elevated with pedicle and transferred to the recipient site. Donor site was covered up with skin graft. Result: After follow up the homo digital island flap was healed nicely and the skin graft take was 100%, length is less diminish, sensibility conformed with two-point description, joint flexibility is good.Summary: Homodigital island flap is a useful safe option for fingertip or distal phalangeal reconstruction because it offers multiple advantages in comparison with advancement, regional, and free flaps, with an almost negligible donor site defect and can be done in a 1-stage procedure.

Squamous Cell Carcinoma Arising From Marjolin’s Ulcer Due To Post Burn Scar: A Case Report Atmowirdjo, Parintosa; Laidding, Sachraswaty
Jurnal Plastik Rekonstruksi Vol. 1 No. 1 (2012): January Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Marjolin’s ulcers are a rare squamour cell carcinomas which develops in non-healing scar tissue. The most frequent predisposing lesion is in a post burn wound, especially after flame burns. Incidence appears to be on the rise and outcome of treatment remains poor. A 51-years old male with burn scar at the posterior left calf since 43 years ago. After burnt, the wound was left to heal spontaneously with minimal treatment. Three years later an unhealing wound emerged on the scar. This wound got bigger, spreaded further, turned into a mass 15 x 8 x 5 cm in size. The tumor was mobile, ulcerative with unprovoked bleeding, malodorous, and painful. Biopsy and imaging concluded a diagnosis of Squamous Cell Carcinoma from Marjolin’s Ulcer, Stage III (T4N0M0). Wide excision was performed 1-2 cm from hiperemis area, neighboring muscles sacri"ced. Frozen section revealed a free-tumor margin and wound covered by split thicknes skin graft. On folllow up, STSG’s “take” was 100%. Four months postoperation, a wound the size of 1 x 1 x 0,5 cm appeared at the distal left posterior calf. Biopsy was performed, result showed granulating tissues with no sign of malignancy. The wound was treated in the outpatient, and healed well. Marjolin Ulcer’s prognosis is not very favorable so it best to prevent at the best first place.

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