Zakaria, Iskandar
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Upper eyelid reconstruction due to scar contracture following major burn injury: A case series Zakaria, Iskandar; Rizal, Syamsul; Irwansyah, Denny; Chintia Amelia Pratiwi
Journal of International Surgery and Clinical Medicine Vol. 4 No. 1 (2024): (Available online: 1 June 2024)
Publisher : Surgical Residency Program Syiah Kuala University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jiscm.v4i1.48

Abstract

Background: Upper eyelid contracture is a regular occurrence after severe facial burns. Numerous problems, such as corneal ulcers and exposure keratitis, may result from it. It is difficult for plastic surgeons to operate in this situation to preserve worst-case scenarios and enhance palpebral function. Methods: In this piece, we showcase two instances: (1) Eight months after suffering a chemical burn injury, a 26-year-old male was diagnosed with bilateral superior palpebral contracture with iris prolapse. Both eyes' visual acuity was 6/6 - 1/¥. A 75-year-old female patient was identified as having a corneal ulcer and a contracture on her left upper eyelid. Both eyes' visual acuity was 20/6 - 1/¥. In order to restore the top eyelid in both patients, we undertook a contracture release and a full-thickness skin graft. Results: Evaluation five days after surgery revealed no evidence of graft lysis and that the graft had taken nicely. On the patient graft from the second, we discovered shifting, although new epithelization will take place. Both of the patients had good eyelid looks following restoration. Conclusion: Plastic surgeons should be aware of the seriousness of significant burn injuries to the face. Patients must receive appropriate instruction on the significance of avoiding consequences from eyelid contractures. In this instance, creating the top eyelid via a skin graft and contracture release technique made sense. We acknowledge that one of the limitations of our study is the brief observational period of the patient's conditions.
Manifestasi klinis, pemeriksaan penunjang, diagnosis dan tatalaksana abses paru pada anak Bakhtiar, Bakhtiar; Herdata, Heru Noviat; Liansyah, Tita Menawati; Zakaria, Iskandar; Sufriani, Sufriani; Safana, Garsia
Jurnal Prima Medika Sains Vol. 5 No. 1 (2023): Juni
Publisher : Program Studi Magister Kesehatan Masyarakat Universitas Prima Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34012/jpms.v5i1.3909

Abstract

Abses paru merupakan rongga berdinding tebal yang mengandung bahan purulen akibat supurasi dan nekrosis pada parenkim paru yang terlibat. Berdasarkan faktor predsposisi, maka abses paru pada anak dapat dibagi menjadi abses paru primer dan sekunder. Penyebab utama terjadinya abses paru primer adalah Streptococcus pneumoniae atau Staphylococcus aureus. Abses sekunder diperberat oleh penyakit paru, misalnya bronkhiektasis, fibrosis kistik, infark paru. Diagnsosis abses paru pada anak ditegakkan berdasarkan gambaran klinis dan pemeriksaan penunjang. Dicurigai abses paru apabila terdapat keluhan demam dan batuk, dan adanya tanda-tanda konsolidasi paru. Pemeriksaan penunjang diperlukan untuk memperkuat diagnosis abses paru meliputi rontgen dada, ultrasonografi, dan computed tomography (CT Scan). Tatalaksana abses paru meliputi tatalaksana umum dan khusus. Tatalaksana umum meliputi pemberian makanan dan cairan yang cukup dan oksigen. Pemberian oksigen dilakukan jika ada gejala sesak nafas. Selanjutnya, tatalaksana khusus meliputi pemberikan antibiotika, drainase dan tindakan operatif (lobektomi). Antibiotik secara inta vena yang tepat direkomendasikan sebagai terapi awal untuk abses paru. Jika tidak ada perbaikan klinis dan radiologis yang bermakna, maka dipertimbangkan dilakukan drainase. Seterusnya, jika dengan drainase juga tidak ada perbaikan, maka langkah terakhir adalak dilakukan lobektomi.