Jurnal Plastik Rekonstruksi
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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<![CDATA[Curettage and Policresulen Tampon as A Modality Treatment in Management of Verucca ]]>
<![CDATA[Simamora, Huntal]]>;
<![CDATA[Lestari, Puri Ambar]]>;
<![CDATA[Bangun, Kristaninta]]>;
<![CDATA[Sudjatmiko, Gentur]]>
<![CDATA[ Jurnal Plastik Rekonstruksi Vol. 1 No. 5 (2012): September Issue ]]>
Publisher : <![CDATA[Lingkar Studi Bedah Plastik Foundation ]]>
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DOI: 10.14228/jpr.v1i5.98
<![CDATA[Background: Verruca, also known as warts is a skin disease characterized by epidermal growth. Verruca may occur anywhere especially on palms and soles. It appears as a rough, dark-grey colored surface and has similar features with clavus or callus, which frequently lead to inappropriate management.Patient and Method : We report two cases with verruca, one was on sole and another was on palm area treated with curettage and chemical ablation using policresulen solution. Both cases have histories of recurrences from the previous treatment, which was excision and primary closure.Results : The wound healed within seven days after treatment. There were no recurrences found after 6-month follow up.Summary : Our treatment (curettage and chemical ablation using policresulen) has two advantages: (1) it can avoid excessive tissue removal since this lesion only afect epidermal layer.]]>
<![CDATA[Management of Patient with Closed Degloving in the Pelvic Region: a Case Series ]]>
<![CDATA[Atmadja, Tessa Miranda]]>;
<![CDATA[Sudjatmiko, Gentur]]>
<![CDATA[ Jurnal Plastik Rekonstruksi Vol. 1 No. 5 (2012): September Issue ]]>
Publisher : <![CDATA[Lingkar Studi Bedah Plastik Foundation ]]>
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DOI: 10.14228/jpr.v1i5.99
<![CDATA[Background: Degloving injuries in pelvis, torso and extremities present a challenge in wound management. Current management usually is the effort to provide wound coverage with split thickness skin graft (STSG). Problems arise in the wound bed preparation because the patient is not mobile, urine or feces contamination, and systemic problems such as anemia, hypoalbuminemia and sepsis. After wound coverage with STSG, problems arise during postoperative period caused by dificulty to maintain immobilization of the graft due to the location.Patients and Methods: In January to February 2012, 3 patients were admitted to Cipto Mangunkusumo hospital with degloving in the pelvic region. They were treated with delayed STSG.Results : The first patient underwent delayed STSG with a 75% take. The second patient was treated by serial STSG a month following hospital admission, the result was almost 90% take. The last patient underwent debridement and the wound was closed with STSG 10 days after admission, the result was only 50% take.Summary : Management of degloving patients should include adequate wound bed preparation with dressing that minimize infection and enhance good granulation tissue, maintain good systemic condition by providing adequate nutrition with care to albumin and electrolyte loss. Care should be given to prevent SIRS and sepsis. After wound coverage with STSG, modalities to immobilize the graft and maintain ideal environment for graft take have to be considered.]]>
<![CDATA[Therapy For Unilateral Lower Extremity Lymphedema With Compression Bandage Only Or Compression Bandage Combined With Surgery ]]>
<![CDATA[Hakim, Intan Frischilla]]>;
<![CDATA[Sudjatmiko, Gentur]]>
<![CDATA[ Jurnal Plastik Rekonstruksi Vol. 1 No. 5 (2012): September Issue ]]>
Publisher : <![CDATA[Lingkar Studi Bedah Plastik Foundation ]]>
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DOI: 10.14228/jpr.v1i5.100
<![CDATA[Background: Lymphedema on lower extremity is a disorder which is still hard to manage nowadays. Many therapeutic modalities had been done, but there weren’t any satisfying outcome. It is all due to the continuous exudation of the lymph which is rich in protein to extravascular that induce tissue inflammation and soft tissue fibrosis process. In case of constriction band, the lymph trapped in the lower extremity, so it also requires surgical procedure.Patient and Method : We reported 2 cases, a woman 71 years old with right limb lymphedema with vulva polyp and a man 58 years old with constriction band on chronic left limb lymphedema and right limb poliomyelitis. We conducted circumference measurement of afected limb 5 minutes after application compression bandage in first two weeks. Case one had quiet good result with compression bandage only while in case two continued with surgical procedure consist of mass reduction using suction-assisted lipectomy, z-plasty constriction band release continue with excise skin redundancy. In both patients pressure garment used for daily treatment.Results : Both patients gave aceptable result on compression bandage in acute case and in chronic case was continued with surgery. Summary : Management for lymphedema can be done by conservative therapy in acute case when edema is in pitting formor combined with surgery when in chronic case, then pressure.]]>
<![CDATA[Chimeric Flap for Reconstruction of Severe Traumatic Injuries of the Hand (a Case Report) ]]>
<![CDATA[Atmodiwirjo, Parintosa]]>;
<![CDATA[Harihadi, Eko]]>
<![CDATA[ Jurnal Plastik Rekonstruksi Vol. 1 No. 5 (2012): September Issue ]]>
Publisher : <![CDATA[Lingkar Studi Bedah Plastik Foundation ]]>
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DOI: 10.14228/jpr.v1i5.101
<![CDATA[Background: Injuries of the hand, including loss of digits, are devastating events. Patients often require multiple operative procedures, with prolonged recovery periods. The challenge for the reconstructive surgeon is to minimize the number of operations, shorten the recovery period, and restore the function and aesthetic appearance of the hand. When faced with a difficult reconstruction, the expense, morbidity of the donor site, and operative time must be taken into consideration. The chimeric composite flaps is combination of microanastomoses consist of two flaps or tissue, each with an isolated pedicle and a single vascular source. Patients and Methods: We reported a case of 32-year-old man presenting with skin defect of hand, flexor and extensor tendon expose due to traffic accident after passed critical event and debridement we did chimeric flaps consist of free radial forearm flap and free dorsalis pedis flap based on radial pedicle system and dorsalis pedis pedicle system. Result: 2 weeks postoperative, flap were vital with satisfactory functional and aesthetic outcome and almost all of graft was take as well as all of donor site graft.Summary: In selected cases, the chimeric flap is a good option for the reconstruction of extensive, composite, and three-dimensional defects.]]>
<![CDATA[Accelerated Healing of The Wider Lateral Defects in Adult Cleft Palate Repairs ]]>
<![CDATA[Mukarramah, Dewi Aisyah]]>;
<![CDATA[Sudjatmiko, Gentur]]>
<![CDATA[ Jurnal Plastik Rekonstruksi Vol. 1 No. 5 (2012): September Issue ]]>
Publisher : <![CDATA[Lingkar Studi Bedah Plastik Foundation ]]>
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DOI: 10.14228/jpr.v1i5.102
<![CDATA[Background: Adult primary palatoplasty is more challenging tha n in infants because the gaps are wider. The risk ofintraoperative bleeding and palatal fistula are higher. Most adults with un-operated palatal cleft have good maxillary growth but poor speech. The aim of this study is to introduce our technique in repairing wide cleft palate in adult patients. Patients and Methods: We report four patients with cleft palate who underwent palatoplasty at adulthood. The age ranges from 17 to 20 years. Interspina distance were between 2 to 3.5 cm. All of them were nonsyndromic and had normal maxillary growth. The surgical technique used on these patients was two-flap palatoplasty with an additional 3 mm gingival bulk on the lateral side of the flap. Honey was given as oral drops postoperatively. Result: Lateral palatal defect healed well and epithelialized completely between 7 -14 days postoperative and only one small palatal fistula was found with this modified technique. All subjects had good maxillary growth, and speech outcome was poor to begin with.Summary: Two-flap palatoplasty can adequately provide palatal closure, especially with an additional lateral flap extension to include gingival components. This extension widens the flaps and aid palatal closure by not leaving lateral defects too wide.]]>
<![CDATA[Frontoethmoidal Encephalomeningocele Revisited : The Convenience Of Teamwork Approach, A CaseSeries ]]>
<![CDATA[Kusumastuti, Nadia]]>;
<![CDATA[Handayani, Siti]]>;
<![CDATA[Hatibie, Mendy]]>;
<![CDATA[Diah, Enrina]]>;
<![CDATA[Bangun, Kristaninta]]>
<![CDATA[ Jurnal Plastik Rekonstruksi Vol. 1 No. 5 (2012): September Issue ]]>
Publisher : <![CDATA[Lingkar Studi Bedah Plastik Foundation ]]>
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DOI: 10.14228/jpr.v1i5.103
<![CDATA[Background: Frontoethmoidal encephalomeningocele (FEEM) is a congenital defect of the skull which poses many problems to the patient as it results in many craniofacial and neural morbidities. While recently surgical correction of this disease is done in a single-stage procedure, many in Indonesia still perform twostage surgery which bears more risks and is technically difficult to achieve good aesthetic results. This case series intend to assess the feasibility and convenience of teamwork approach between plastic surgeon and neurosurgeon in correcting FEEM in a single-stage operation. Methods:We reviewed 8 patients with FEEM treated in Plastic and Reconstructive Surgery Division, Cipto Mangunkusumo Hospital Jakarta from November 2005 until March 2010. Four of the cases were secondary cases from Neurosurgery Department, and the other 4 cases were treated in single-stage operation, in teamwork with Neurosurgery Department, using the Chula technique. Results of each surgery was assessed using objective parameters, which are Intercanthal Distance (ICD) and Interorbital Distance (IOD); and also subjective parameters which is aesthetic improvement.Result: All of the patients showed significant improvements in ICD and IOD measurements. No complication was found intra and post-operatively. All patients, especially the ones treated with singlestage surgery show good aesthetic results. Conclusion: To achieve goals of defect correction and aesthetically pleasant appearance, single-stage surgery in teamwork with the neurosurgery department seems to be most suitable and convenient.]]>
<![CDATA[Management of Traumatic Undiagnosed Condyle Fracture in Children ]]>
<![CDATA[Rizal, Syamsul]]>;
<![CDATA[Kreshanti, Prasetyanugraheni]]>;
<![CDATA[Handayani, Siti]]>;
<![CDATA[Bangun, Kristaninta]]>
<![CDATA[ Jurnal Plastik Rekonstruksi Vol. 1 No. 5 (2012): September Issue ]]>
Publisher : <![CDATA[Lingkar Studi Bedah Plastik Foundation ]]>
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DOI: 10.14228/jpr.v1i5.104
<![CDATA[Background: Condyle trauma is considered to be the major cause of TMJ ankylosis but it is also the most neglected and under-managed problem in children. ?TMJ ankylosis leads to be malocclusion and facial disfigurement. The aim of early treatment is to restore the mandibular mobility and to enhance further growth in order to reduce the possibility of future facial asymmetry. Patients and Methods: We report two patients with inability to open mouth few months following injury. They most probably suffered missed diagnosis condyle fracture by the previous physician. The latest physical examination and radiological finding shows the mandible was micrognathic and unilateral TMJ ankylosis was confirmed. A sequential protocol of TMJ ankylosis management based on aggressive resection of ankylotic mass was performed and followed withphysiotherapy.Result: In 2 month-follow up, both patients showed significant improvement in mouth opening and the mastication function was restored, accompanied with physical therapy to gain maximum mouth opening for at least a year.Summary: A detail history, clinical and functional examination, radiographic examination facilitating correct diagnosis followed by immediate surgical intervention, and physiotherapy can help us to restore physical, psychological, and emotional health of the child patient.]]>
<![CDATA[The Effect Of Honey Give As Oral Drops In Precipitating Epithelialization Of Lateral Palatal Defects Post TwoFlap Palatoplasty ]]>
<![CDATA[Kreshanti, Prasetyanugraheni]]>;
<![CDATA[Sudjatmiko, Gentur]]>;
<![CDATA[Bangun, Kristaninta]]>
<![CDATA[ Jurnal Plastik Rekonstruksi Vol. 1 No. 5 (2012): September Issue ]]>
Publisher : <![CDATA[Lingkar Studi Bedah Plastik Foundation ]]>
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DOI: 10.14228/jpr.v1i5.105
<![CDATA[Background : Two-flap palatoplasty, which is a very common technique used including in our institution, will result in lateral palatal defects without any periosteal coverage. Faster epithelialization is expected to decrease wound contraction thus reducing scar formation, and in the long run will result in good maxillary growth. In our institution, the retrospective study showed a fair maxillary growth (mean GOSLON score=3.5). Thus, we explore possibilities to precipitate the epithelialization process in pursuit of good maxillary growth in the future.Method :This is a prospective cohort study conducted in Cipto Mangunkusumo Hospital, on consecutive patients who underwent two-flap palatopasty from October 2010-February 2011. We followed up these patients weekly for 4 consecutive weeks to observe the rate of epithelialization of the lateral palatal defects.Result : Two-flap palatoplasty was performed in 48 patients, 23 among them were given honey as oral drops. Eighty-seven point five percent had unilateral complete cleft lip and palate and 12.5% had bilateral complete cleft lip and palate. Faster epithelialization of the lateral palatal defects post two-flap palatoplasty was significantly in!uenced by intraoral honey application on the wound as oral drops (RR 2.1, 95% CI 1.314 - 3.391, p < 0.001).Conclusion: Honey given as oral drops significantly precipitates the epithelialization process of the lateral palatal defects post two flap palatoplasty 2.1 times faster.]]>
<![CDATA[Traumatic Palatal Defect Closure With Prosthesis Post Surgical Reconstruction: A Team Approach ]]>
<![CDATA[Martina, Nungki Ratna]]>;
<![CDATA[Kreshanti, Prasetyanugraheni]]>;
<![CDATA[Handayani, Siti]]>;
<![CDATA[Bangun, Kristaninta]]>
<![CDATA[ Jurnal Plastik Rekonstruksi Vol. 1 No. 5 (2012): September Issue ]]>
Publisher : <![CDATA[Lingkar Studi Bedah Plastik Foundation ]]>
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DOI: 10.14228/jpr.v1i5.106
<![CDATA[Background: Palatal defect may be a result of congenital malformations, trauma or tumors. In most maxillopalatal trauma, surgical reconstruction is required to restore the function and appearance. Any palatal defect caused by maxillopalatal loss that cannot be achieved with surgical reconstruction needs special and comprehensive treatment. This can be done by prosthodontist prosthesis rehabilitation.Patients and Methods: A 20-year-old man underwent open reduction and internal fixation for severe maxillopalatal fracture and palatal loss. Intraoperative, the palatal defect could not be approximated due to palatal loss. In 3-month-follow up, there was a palatal defect and slight malocclusion due to anterior dental loss. Instead of performing complicated surgical procedures, we collaborate with the prosthodontist to assemble prosthesis with dental prosthesis that accommodate the closure of defect and improve appearance aesthetically. Result: The use of prosthesis improves functional and psychological wellbeing. It does not only close the palatal defect, but it also fills the anterior dental loss thus overcoming the malocclusion. Satisfying functional and aesthetic outcome was achieved. Summary: Rehabilitation of maxillopalatal defect has been well defined for prosthodontists and surgeons. A successful prosthetic design for functional restoration of the palatal defect utilizes the remaining palate and dentition to maximize the support, stability and appearance. In this case,prosthodontist and dentition prosthesis was used as modalities that offer simple solution to close the palatal defect compared to a more complicated surgical intervention.]]>
<![CDATA[Fetal Bovine Serum Substitute: Implication for Their Use in Translating Adipose-Derived Stem Cells from Bench to Bedside (Review) ]]>
<![CDATA[Josh, Fonny]]>;
<![CDATA[Mizuno, Hiroshi]]>
<![CDATA[ Jurnal Plastik Rekonstruksi Vol. 1 No. 5 (2012): September Issue ]]>
Publisher : <![CDATA[Lingkar Studi Bedah Plastik Foundation ]]>
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DOI: 10.14228/jpr.v1i5.107
<![CDATA[Recently, cell based therapy become a popular topic in research fields. This therapy offers great potential to treat many diseases. Adipose-derived stem cell (ASCs) is known to have the special characteristic due to its abundant availability and easily harvesting. Then it rapidly advanced into clinical trials for treatment of a broad range of medical conditions. Before translating ASCs from bench to bedside, this process is facing other problems through fetal bovine serum (FBS) elimination. Animal-derived serum is not a suitable option for ASCs expansion regarding the possibility of viral or bacterial infection and immune reaction. By replacing FBS with other non-animal serum which gives the same effect as FBS, may significantly enhances the safety and quality of ASCs. Pooled human AB serum (AB-HS), human serum (HS), pooled human plasma lysate (PL), umbilical cord serum (UCS)/placental serum (PS), thrombinactivated platelet rich plasma (tPRP) or serum free (SF)/xeno-free (XF) have been considered as FBS alternatives and some already applied in clinical trials with human cells. This article focuses on a prospective alternatives serum through the elimination of FBS.]]>
