Nata’atmadja, Beta Subakti
Department Of Plastic Reconstructive And Aesthetic Surgery, Faculty Of Medicine Universitas Airlangga

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Comparison of the Total amount of Macrophages on Full Thickness Wound Bed in The Use of Tulle, Freeze-Dried Amnion, and Microbial Cellulose Saktrio Darmono S.1, Beta Subakti Nata’atmadja1, David Sontani Perdanakusuma1
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 2 (2020): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v14i2.3218

Abstract

Background: The wound is the most frequent problems faced by plastic surgeon. Many factors can affect the wound healing process. Macrophages are as one indicator of wound healing which present in the wound within 24-48 hours after injury. Currently, there is a variety of wound dressing available which can increase the levels of macrophages in the wound healing process according to previous research. Objectives: To compare the total amount of macrophages on full thickness wound bed in the use of tulle, freezedried amnion, and microbial cellulose on the second day. Material and Method: The study design was experimental, post-test only group design using 21 male rats Rattus norvegicus. The wound was closed with tulle, amnion, and microbial cellulose which was evaluated on the second day. The samples wounds were fixed by 10% formalin solution then examination of samples was conducted by Wright-Giemsa staining routine/Hemato-eosin under a microscope. Results: Macrophages obtained at a given tulle ranges between 41-96, freeze-dried amniotic at 51-142, and the microbial cellulose at 55-96. In other hand, the mean number of macrophages in the wound by the microbial cellulose at 77.4; its 1.3 times higher than the given tulle at 59; meanwhile its 0.9 times lower than the freeze-dried amniotic given by 83. Conclusions: There were no differences in the increase number of macrophages in the wound bed by the use of tulle, freeze-dried amnion and microbial cellulose on the second day.
Surgery and Rehabilitation Following Flexor Tendon Zone II Injury Of The Hand: A Literature Review Loelita Marcelia Lumintang; Beta Subakti Nata’atmadja
Jurnal Plastik Rekonstruksi Vol. 4 No. 1 (2017): January Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (978.724 KB) | DOI: 10.14228/jpr.v4i1.218

Abstract

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.
CLINICAL PROFILES OF FROSTBITE IN DR. SOETOMO GENERAL ACADEMIC HOSPITAL: A CASE SERIES Wahyu Nugroho, Thomas Eduardus Sudrajat; Beta Subakti Nata’atmadja
Jurnal Rekonstruksi dan Estetik Vol. 4 No. 1 (2019): Jurnal Rekonstruksi dan Estetik, June 2019
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (403.792 KB) | DOI: 10.20473/jre.v4i1.24348

Abstract

Highlights: This study presents three cases of frostbite in adults who participated in a Mount Denali expedition, highlighting the treatment process and outcomes. The importance of long-term follow-up management and prioritizing finger preservation and potential reconstruction in patient care. Abstract: Introduction: Frostbite is a common cold-related injury, especially among mountaineers in high-altitude settings. These injuries can occur both in freezing and above-freezing temperatures. The main goal of this study is to understand the clinical aspects of frostbite cases treated at Dr. Soetomo General Academic Hospital in Surabaya. Case Illustration: We present three cases of frostbite in adults who were part of a Mount Denali expedition, reaching an altitude of 6192 meters. Initial treatment included rewarming and pain relief. They were admitted to our facility 11st days after the injury, with one patient undergoing finger amputation on the 71st day. All received standard antibiotics and three days of hospital care. No initial surgeries were performed; instead, wound checks and rehabilitation were done as outpatients. On the 71st day, one patient had the third and fourth fingers amputated. The study found changes in platelet counts during the acute frostbite phase but no significant changes during the subacute phase following cold exposure. Discussion: The cases showed substantial improvements in wound healing, reduced swelling, increased mobility, and overall better health. Clear demarcation of damaged tissue occurred during observation. While frostbite is rare in tropical areas, it can impact individuals in cold-weather activities like mountain climbing and winter sports. Effective prevention and management are vital for good outcomes. Initially, conservative treatment is suggested, but surgery may be needed when the extent of tissue damage is apparent. Conclusions: Long-term follow-up management is necessary to achieve a good functional outcome. Preservation and if necessary reconstruction of the finger should become a priority in the patient management.
DEVIATION AND ATROPHY OF MIDDLE PHALANX OF HAND FOLLOWING PARTIAL SEPARATION IN SYNDACTYLY PATIENT: THEIR FAULT OR OURS? Kusuma, Diana Murtiati; Saputro, Iswinarno Doso; Rizaliyana, Sitti; Beta Subakti Nata’atmadja
Jurnal Rekonstruksi dan Estetik Vol. 3 No. 1 (2018): Jurnal Rekonstruksi dan Estetik, June 2018
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1054.23 KB) | DOI: 10.20473/jre.v3i1.24366

Abstract

Highlights: Complex syndactyly reconstruction presents surgical challenges, often resulting in rotational, angular, and nail deformities post-surgery. The early correction of congenital syndactyly, combined with dorsal rectangular flap usage and full-thickness skin grafts, leads to satisfactory outcomes and reduces the need for multiple surgeries per web Abstract: Introduction: Syndactyly is failure of differentiation in which the fingers fail to separate into individual appendages. It is the most common congenital hand anomaly, with an incidence of 1 in 2,000 to 2,500 live births. Surgical separa­tion of fingers as early as 6 month-old is indicated when syndactyly involves digits of unequal length (i.e., ring and little fingers). Early separation is also required in complex syndactyly and cases of acrosyndactyly. The timing of sur­gery of all other cases of syndactyly remains somewhat controversial; most suggest surgical correction before age of 18 months, whereas others prefer to wait until after this age. Case Illustration: A 13-year old boy, presented with fusion of all fingers of the right hand at birth. Prior to his current visit, he underwent partial separation of the right fingers at the age of 6 y.o. at a local hospital. Following partial separation, the fingers did not grow normally. Cur­rent X-ray showed atrophy and deviation of middle phalanx. We performed separation of syndactyly between index and middle finger, and between fourth and small finger in our hospital. Interdigital webbings are released using local flap and the remaining raw surface is covered using full-thickness skin grafts. On follow up, the patient showed good functional and aesthetic outcome. He is able to write with his right hand with better coordination. Discussion: Complex syndactyly reconstruction is a challenging surgical problem. Common post surgical findings include rotational deformity, angular deformity, and nail deformity. We describe how we have altered our approach in these findings. Conclusion: Congenital syndactyly should be corrected early in life. Careful dissection, the use of a dorsal rectangular flap in combination with 2 volar triangular flaps, and use of full thickness skin grafts ensure a satisfactory outcome and minimize the number of operations per web.
UMBILICAL RECONSTRUCTION WITH DOUBLE OPPOSING SEMILUNAR FLAP, AN APPEALING RESULTS: A CASE SERIES Muharram, Arif Rahmat; Budi, Agus Santoso; Zarasade, Lobredia; Beta Subakti Nata’atmadja
Jurnal Rekonstruksi dan Estetik Vol. 3 No. 1 (2018): Jurnal Rekonstruksi dan Estetik, June 2018
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1008.015 KB) | DOI: 10.20473/jre.v3i1.24367

Abstract

Highlights: A double opposing semilunar flap has good result for umbilicus reconstruction. A double opposing semilunar ensures a natural appearance and avoids visible scarring while maintaining appropriate depth and size. Abstract: Introduction: Umbilical loss is not a common problem encountered in plastic surgery routine cases. The absence of umbilicus will cause significant effect in total aesthetic appearance of the abdomen, thus making it an essential part of anatomy landmark. Congenital defect, oncologic and abdominoplasty complication are the most often causes, and tremendous psychological trauma will cause patient to seek help. Case Illustration: There are many proposed technique for such reconstruction, based on original scar or wound and final expected shape, of course with their advantages and disadvantages. We used a double opposing semilunar flap for our cases. Along with its technical detail, we will present three cases comprises of the defect after omphalocele scar removal, umbilical endometriosis excision and postcentral abdominal tumor excision. Reports will be presented with preoperative and postoperative result. Discussion: This technique avoids the appearance of scarring and secondary stenosis by hiding the circular scar incision and maintaining its position in the middle of the new form. Conclusion: The reconstruction technique of the umbilicus presented for the anatomical units, provides a very natural look, and generates slight excess of skin on the upper part over time and giving a more graceful appearance. 
A COMPARISON OF ABBREVIATED BURN SEVERITY INDEX (ABSI) SCORE WITH R-BAUX SCORE AS A PREDICTOR OF MORTALITY IN BURN PATIENTS Iustitiati, Melissa Anita Ayu; Beta Subakti Nata’atmadja
Jurnal Rekonstruksi dan Estetik Vol. 7 No. 2 (2022): Jurnal Rekonstruksi dan Estetik, December 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jre.v7i2.41216

Abstract

HIGHLIGHTS: 1. The R-Baux Score and ABSI Score can be used as model predictors of death in burn patients at Dr. Soetomo General Academic Hospital.2. There was no significant difference between the R-Baux Score and the ABSI Score as the predictor of mortality in burn patients.   ABSTRACT: Background: Several studies regarding the mortality predictor model in burn patients have been carried out in several cities and countries. However, none have ever happened in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. This study aims to analyze the R-Baux Score and Abbreviated Burn Severity Index (ABSI) Score as a mortality predictor model in burn patients, which are relevant and useable in services at Dr. Soetomo General Academic Hospital. Methods: This study used quantitative research with a cross-sectional design and retrospective design utilizing secondary data. It was found that 263 patients met the inclusion criteria; with 73 patients died, 60.27% of whom were male, 50% with inhalation trauma, 19.18% were in the age range of 56-65 years old, 24.66% had a burn area of 61-70%, and 35.62% with a full-thickness burn. Results: The results showed that the sensitivity value from the ABSI Score (p<0.001) was 82.19%, with a specificity of 82.11%, a positive predictive value of 63.83%, and a negative predictive value of 92.31%. The R-Baux Score (p<0.001) showed that the sensitivity value obtained was 80.82%, with a specificity of 80.00%, a positive predictive value of 60.83%, and a negative predictive value of 91.57%. Conclusion: There was no significant difference between the R-Baux Score and the ABSI Score as the predictor of mortality in burn (p>0.05). Therefore, both the R-Baux Score and the ABSI Score can be used as model predictors of death in burn patients at Dr. Soetomo General Academic Hospital.