Garuda - Garba Rujukan Digital

Large Abdominal Defect Closure: Case Series Nurliati Sari Handini; Melina Tiza; Gentur Sudjatmiko
Jurnal Plastik Rekonstruksi Vol. 3 No. 1 (2016): January Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: We will report some experiences in managing challenging malignant cases on the abdominal wall, including a case of large, irradiated defect. All of those cases were consulted intraoperative immediately following tumor removal. The keystone random perforator flap was chosen among the option of solutions in large abdominal defect closure. This region has natural elasticity, which combines well with the multi-axial tissue recruitment of the flap Methods: Three cases of complicated abdominal defect were reconstructed using the keystone flaps supplied by non-identified (random) perforators. Results: All flaps survived without problem of vascularization, despite of its large defect, sequence of radiotherapy following reconstruction, infection, and with its margin unable to be freed from tumor. One out of three cases suffered from contaminated wound from stomal leakage, leading to dehiscence. Conclusion: The keystone flap is a useful and reliable random perforator-based flap, even in complex and challenging malignant cases of abdominal wall.

Simple Metric Measurement To Choose A keystone Flap Design On Extremities: A Cadaveric Study Narottama Tunjung Hariwangsa; Gentur Sudjatmiko
Jurnal Plastik Rekonstruksi Vol. 3 No. 1 (2016): January Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Closing defect on extremities can be challenging because of limited donor area in order to obtain similar quality, color, texture, and adequate size with the defect. The keystone flap has gained popularity as a tool for local reconstruction because of its simple design, short operative time, good aesthetic outcome, and cost-effective wound closure. The aim of this study is to introduce a method in choosing a keystone flap design based on simple metric measurement resulting in lower tension.. Methods: Four circular defects were created on 4 different regions of a fresh cadaver’s upper limbs. Diameters were 5 cm for upper arms and 3 cm for lower arms. Two options of keystone flaps designs were introduced. The keystone could be advanced in longitudinal manner or in transversal manner according to limb’s axis. We then calculated the percentage of the skin required to stretch, in order to close the defects. The less percentage of skin required to stretch between the two manners indicated the lower tension of the keystone flap. Results: Measurements in all of 4 regions of upper limbs showed that the percentage of skin stretch in closing the defects was lower in longitudinal advancement keystone flap compared to transversal advancement (19.88% versus 27.8% for upper arms and 15.71% versus 21.67% for lower arms) Conclusion: Simple metric measurements in choosing a keystone flap can be applied to defects on extremities. With less tension when raising the keystone flap, acceptable scar is expected and the occurrence of contracture and flap necrosis can be reduced.

Antropometric Evaluation Of Gentur's Cheiloplasty Method In Unilateral Cleft Lip Rani Septrina; Gentur Sudjatmiko
Jurnal Plastik Rekonstruksi Vol. 3 No. 2 (2016): July Issue
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 Kristaninta Bangun; Nurina Widayanti; Gentur Sudjatmiko
Jurnal Plastik Rekonstruksi Vol. 3 No. 2 (2016): July Issue
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.

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

The Use Of Control Suture In Cleft Lip Surgery Gentur Sudjatmiko; Mohamad Rachadian Ramadan
Jurnal Plastik Rekonstruksi Vol. 1 No. 6 (2012): November Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

To achieve an optimal result in cleft surgery, executing the proper designs and precise techniques are mandatory. Several techniques are proposed for the repair of unilateral and bilateral cleft lip. In 1955, Millard !rst described the techniques of advancing a lateral upper lip "ap combined with downward rotation of the medial segment.1 From experience, the above- mentioned technique may be modi!ed to facilitate better lip rotation and symmetry. Technically, it also provides a more ef!cient work"ow and more accurate results. All efforts in lip repairs have one ultimate goal, which is to achieve corrected lips with minimal scar and as much resemblance to that of the normal lips: by anatomy, symmetry, and muscle function.

Title

Found 6 Documents
Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title Search

Found 6 Documents Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title

Found 6 Documents
Search