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Jurnal Plastik Rekonstruksi

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Published by Yayasan Lingkar Studi Bedah Plastik

ISSN : 20896492 EISSN : 20899734 DOI : -

Core Subject : Education, Engineering,

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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.

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Articles 16 Documents

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Search results for , issue "Vol. 1 No. 4 (2012): July Issue" : 16 Documents clear

Acromiocervical Flap As One of the Modality To Reconstruct Post-Burn Neck Contracture: A Case Report Irwansyah, Denny; Sandhi, Afriyanti; Heryadi, Eko; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 4 (2012): July Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Abstract: Postburn neck contractures are frequent and may cause gross facial deformity and severe functional disability. Reconstruction of these deformities is challenging, especially to plastic surgeon. Several methods have been published including skin graft, local flap and free flap. Patient and Method: The case presented in this paper is a postburn neck contracture which had been managed by two plastic surgeons in two different hospitals. This deformity limits the normal function of eating, speaking and appearance of this patient. Skin graft was used to correct this deformity but in the next few months neck contracture recurred. Result: It results in minimal disability and in overall improved functional and appearance outcome. We report our experience using the acromiocervical flap on a case for reconstruction of neck contracture with a goal to prevent recurrence.Summary: Skin Grafting is not an easy and simple procedure for reconstruction of the neck contracture. It requires comprehensive rehabilitation program including prolonged neck splinting and patient compliance. Considering those difFIculties acromiocervical flap can be one of the modality to reconstruct post burn neck contracture because it is relatively simple and reliable.

Management and Treatment of Gynecomastia with Liposuction Sari, Tessa Puspita; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 4 (2012): July Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Gynecomastia is a common problem of the male breast, with a reported overall incidence of 32 to 36 percent. The surgical management of gynecomastia has undergone significant changes over the past few decades, from a predominantly open approach to one involving liposuction only or liposuction combined with direct excision through a periareolar or remote incision. Patients and Method: We present five cases with bilateral gynecomastia. One patient is a teenager and others are adult males. Liposuction only was performed in patients without palpable glandular breast mass. Direct excision was made to help remove the excessive glandular breast mass. The compressive garment is worn for 4 to 6 weeks after procedure to prevent the complications of the surgical procedure.Result: Three of the patients are corrected with liposuction only. There are two patients who underwent combination of open excision and liposuction. The liposuction procedure only left minimal scar from canulas incision. Other patient has minimal periareolar incision to remove excess breast tissue. None of the patients showed complication after surgery.Summary: All of the patients presented were satisfied by the correction of gynecomastia using liposuction. None of the patients shows any complication after liposuction procedure. The result after surgery is a natural-looking chest without extensive scar. The patients appreciate the early return to work and normal physical activities.

The Extended Lateral Forehead Flap: Today as Was 50-years Ago Supit, Laureen; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 4 (2012): July Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: In the era of surgical advances where institutional pride and status resonates with their progress in the minimal invasives, latest technologies, stem cells, and supermicrosurgeries; some things in plastic surgery never change. The extended lateral forehad flap (ELFF) was first introduced by Ian McGregor in 1963 to reconstruct an intraoral defect, he called it the temporal flap. Gillies and Millard each modified and utilized the flap for patching various facial and intraoral defects and published their experience a year later. Until today in 2012, the ELFF is still largely useful for the reconstruction of wide defects post neoplasms ablation in the face or oral region, which would otherwise require distant flaps or free flaps.Patients and Methods: Three cases of oral and perioral carcinoma were resected and reconstructed using the ELFF to cover for: a full-thickness cheek defect including the lip commisure, an inner oral lining, and a hemipalatal defect.Results: In all, the flaps were tunneled subcutaneously, and donor area grafted by full-thickness skin. All flaps survived and functional outcomes are attained in all patients, with acceptable aesthetic results.Summary: A flap once introduced 49 years ago, is today as consistent and applicable in plastic surgery. This article is an appraisal to the ELFF, and a reminder to the general plastic surgeons, of the simple yet versatile role of ELFF in the reconstruction of facial and intraoral defects.

Evaluation of Free Tissue Transfer in The Reconstruction of Soft Tissue Defect in The Leg Atmodiwirdjo, Parintosa; Hendra, Fakhrul
Jurnal Plastik Rekonstruksi Vol. 1 No. 4 (2012): July Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: There are many possible reconstructive options for reconstruction of defects in the lower limb. These include:skin grafts, local flaps, distant flaps and free flaps.Patients and Methods: We present four cases with soft tissue defects in the legs who were admitted to the Plastic and Reconstructive Surgery Division, Cipto Mangunkusumo Hospital, Jakarta, between February 2009 and February 2010. Result: In all four cases, the free anterolateral thigh (ALT) flaps have been performed for reconstruction of soft tissue defect in the upper third of the leg (3 patients) and lower third of the leg (1 patient). The cause of soft tissue defect was trauma in 3 patients and malignancy in 1 patient. All of the donor sites have similar size with the defect tissue with 15 to 20 cm in length and 10 to 15 cmin width. End-to-end microvascular anastomosis was performed in 2 cases while end-to-side anastomosis was done in the other 2 cases. Arterial thrombosis and infection were complications found in early post-operative period. Arterial thrombosis caused failure in 1 case of free ALT flap which were reconstructed further with free radial forearm flap. Summary: Free ALT flap is relatively easy to harvest once the technique of perforator flap dissection has been learnt. It has a reliable blood supply despite some anatomic variability, it is pliable and can be thinned to a significant degree without compromising blood supply, and can provide a long pedicle with large-diameter vessels.

Pectoralis Major Musculocutaneous Flap and Splitthickness Skin Graft for The Reconstruction of Pharyngocutaneous Fistula After Total Laryngeal Resection Atmodiwirjo, Parintosa; Pribadi, Sweety
Jurnal Plastik Rekonstruksi Vol. 1 No. 4 (2012): July Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Pharyngocutaneous fistula (PCF) is the most frequent complication in the early postoperative period after total laryngectomy. Most PCF respond well to conservative management, but when it fails and the fistula persists surgical closure in indicated. Patients and Methods: Sixty-five year-old male was consulted to our division following total laryngectomy by the Ear Nose Throat surgeons, with wound dehiscence and pharyngocutaneous fistula. We performed a pectoralis major musculocutaneous flap (PMMCF) to close the fistula after a failed conservative management. The skin island of PMMCF was used as an inner lining to close the laryngeal fistula, the exteriorized muscle part of the "ap was then covered by skin graft.Results: PMMCF is a technically simple and reliable distant musculocutaneous pedicled flap to cover defect on the neck area. The skin island of the flap provided an adequate air-thight cover and successfully closed the laryngeal fistula.Summary: PCF is a problematic complication resulting from the resection of head and neck tumor. Early diagnosis and proper multidisciplinary management is required to prevent further morbidity. PMMCF is a simple, easy to perform and reliable option for closure of PCF.

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.

Maxillary Growth and Speech Outcome in Patient with Cleft Lip and Palate after Two-Stage Palate Repair: A Systematic Review Mulyadi, Mulyadi; Kreshanti, Prasetyanugraheni; Handayani, Siti; Bangun, Kristaninta
Jurnal Plastik Rekonstruksi Vol. 1 No. 4 (2012): July Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: The management of patients with cleft lip and palate is complex, where the treatment outcome is judged on the balance between aesthetics, speech, and maxillary growth. Up to now, there is no generally accepted treatment protocol. Every center must find the best-suited protocol treatment for their population. Methods: A systematic review through literature search was conducted for English-language studies in PubMed. This search was conducted in September 2011 using EndNote X3 with keywords: Two-stage Palate Repair and Maxillary Growth and Two-stage Palate Repair and Speech Outcome. Both retrospective and prospective studies on maxillary growth and speech outcome in patient with cleft lip and palate after two-stage palate repair published from 2001 to 2012 were included. Result: From the reviewed of 37 articles, only 14 articles fit the inclusions criteria, three articles discussed the outcome of maxillary growth and speech outcome, eight articles only discussed the maxillary growth and the rest of articles only discussed the speech outcome. Conclusion:From this review we found that most of the two-stage palate repair results in better maxillary growth, but only few of them results in good speech outcome. We will perform further study based on this review to discover a new protocol for the management of palate repair in our center.

Secondary Rhinoplasty On Cleft Lip Nose Sudjatmiko, Gentur; Kreshanti, Prasetyanugraheni
Jurnal Plastik Rekonstruksi Vol. 1 No. 4 (2012): July Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

By definition a secondary rhinoplasty is a procedure to correct the nasal shape deformity in cleft lip patients, which is performed not in conjunction with the labioplasty procedure. Several important factors to be considered in doing rhinoplasty procedures in cleft lip patients are: (1) Open rhinoplasty is more beneficial in assessing the whole nasal deformity, especially the nasal cartilage in cleft lip patients, (2) Releasing the latero-superior cartilage attached to the nasal bone and skin, which caused webbing inside the nostrils, (3) Addition of strut in columella as a pillar to adjust the dropping nose to the upright position, (4) Addition of cartilage plate whenever needed in the cleft side, (5) The nostril narrowing on the cleft side could be reduced by enlarging the nostril diameter, (6) The new nostril shape is maintained using a device (nasal retainer) for several weeks until the healing process is achieved, (7) The suture removal in nose is not as easy as of those in lip. The suture removal could be performed under mild sedation especially in uncooperative patients.

Speech Outcome in Cleft Palate Patients After Soft Palatoplasty (Stage 1) in Two-Stage Palatoplasty Technique: A Review of Two Cases Sutrisno, Eddy H; Wahyuni, Luh K.; Lilisantosa, Kartika
Jurnal Plastik Rekonstruksi Vol. 1 No. 4 (2012): July Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: The challenge in palatoplasty is no longer a successful closure of the cleft palate but an optimal speech outcome without compromising maxillofacial growth. On the contrary, repairing cleft palate as soon as possible is recommended to improve speech. The surgeon proposed two-stage palatoplasty in early aged, range between 4 to 30 months. The delayed hard palate closure started approximately between the age of three years and one year after soft palatoplasty to avoid temporary retracted oral articulation of certain consonant. Patient and Methods: 11-months old and 9-months old patients with non-syndromic unilateral cleft lip and palate had undergone soft palatoplasty. Speech was examined as a perceptual assessment, using protocol in Craniomaxillofacial Center Cipto Mangunkusumo Hospital, in the age of 29 months by an experienced speech pathologist. Result: Patient 1 has mild hypernasality, adequate velopharyngeal competence, normal articulation pattern, phonation and speech intelligibility. Patient 2 has misarticulation pattern,which are omission or weak consonants, substitution of pharyngeal stop, mild to moderate hypernasality, mild impairment in speech intelligibility, and inadequate velopharyngeal competence.Summary: Speech outcome is influenced by intense speech practicing done by their parents. The patient can work on the misarticulation. We need further study to know the result of speech outcome in two stage palatoplasty.

The Experience of Using Various Modalities For Orbital Floor Fracture Reconstruction Prawoto, Pujisriyani; Handayani, Siti; Bangun, Kristaninta
Jurnal Plastik Rekonstruksi Vol. 1 No. 4 (2012): July Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Fractures of the orbital floor require surgical intervention in group of patients with cosmetic problems and/or vertical diplopia. The surgical management of these patients provides a great challenge to the surgeon. A variety of implant materials have been used to recreate normal bony orbital dimension or supplement deficient orbital volume which include alloplastic or autogenous materials. The purpose of this case series was to assess the aesthetic and functional outcome of orbital floor reconstruction performed with calvarial bone graft, titanium mesh, absorbable mesh and “Turkish Delight” diced cartilage graft.Patients and Methods: From 2006-2010, we treated eight patients with orbital blowout fracture using various modalities. We used titanium mesh, absorbable mesh, calvarial bone graft and “Turkish delight” diced cartilage. These various modalities were chosen based on clinical examination, patient satisfaction, radiographic investigations and the cost on managing patient.Result: Calvarial bone graft were performed in two patient, “Turkish delight” diced cartilage in one patient, absorbable mesh in one patient, and titanium mesh in four patient. All patients had satisfactory result with adequate volume correction and reduction in vertical diplopia.Summary: All four materials, calvarial graft, titanium mesh, absorbable mesh, and “Turkish delight” diced cartilage graft have the potential to be useful reconstructive materials in orbital floor blowout fractures based on holistic consideration.

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