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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,

Civil Engineering, Building, Construction & Architecture Other

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.

Arjuna Subject : -

Articles 202 Documents

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Free Vascularized Dermofat Flap For Contouring Maxilla In Fibrous Dysplasia Patients Atmodiwirjo, Parintosa; Martina, Nungki Ratna
Jurnal Plastik Rekonstruksi Vol. 1 No. 2 (2012): March Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Fibrous dysplasia is a disease that causes bone thinning and growth of lesions in one or more bones and leads to bone weakness and scar formation within the bones. Especially when involving the skull or facial bones, the lesions can cause externally visible deformities. We reported one case of fibrous dysplasia of the maxilla reconstructed in our Plastic Surgery Division of Cipto Mangunkusumo Hospital. Data was taken from the medical and surgery records. In this case, we used the Antero Lateral Thigh (ALT) flap to reconstruct the maxilla and facial contour in 26 years old girl with fibrous dysplasia. After the operation we had daily observation to evaluate the blood flow to the flap and it had satisfactory result without any complication. Ultimately, free vascularized dermofat flap with ALT seems to be suitable for craniofacial contouring surgery, in this case for contouring maxilla. Facial contour could further be improved after secondary reshaping of the healed flaps. This led to nearly perfect long-term facial symmetry in all cases. The ALT proved to be a reliable donor site, providing enough well-vascularized fatty tissue for facial contour augmentation.

Revisited Anterolateral Thigh Free Flaps For Reconstructive Microsurgery : One Year Evaluation Atmodiwirjo, Parintosa; Handayani, Siti; Djaprie, Shelly Madona
Jurnal Plastik Rekonstruksi Vol. 1 No. 2 (2012): March Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Extensive soft tissue defects present a dif!cult problem to the plastic surgeon as they are usually associated with exposed important structures such as vessels, nerves, tendons, joint cavity or bone. Reconstruction of soft tissue defects have a wide range of therapeutic options. We reconstructed soft tissue defect in many areas using free anterolateral thigh flap (ALTF). From Februari 2009 - 2010, 9 cases of soft tissue defects in the face, neck, leg and foot of various etiologic factors were admitted to the plastic and reconstructive surgery unit, Cipto Mangunkusumo general hospital. Trauma is the commonest cause of soft tissue defects of the lower extremity, followed by tumours. The cruris was the commonest site (4 cases, 44,4%). Flap success rate was 66,67 %. Failure was reported 1 cases in this study due to vein compromise. In our hospital, we are quite familiar with Anterolateral thigh flap (ALTF) even though the case is limited. Anterolateral thigh flap (ALTF) is used for reconstruction of various simple and complex soft tissue defects, for big and small defects with cavity (orbita).

Evaluation of Facial Trauma Severity in Cipto Mangunkusumo Hospital Using FISS Scoring System Bangun, Kristaninta; Kesuma, Ayu Diah
Jurnal Plastik Rekonstruksi Vol. 1 No. 2 (2012): March Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Many scoring systems were introduced to search prognostic value in trauma patients. Facial trauma is a special trauma because it can cause many disabilities in facial function. There have been several reports on facial severity scoring system, such as Facial Injury Severity Score (FISS) and Maxillofacial Injury Severity Score (MFISS). Although these scoring systems have been introduced in many journals, they are not yet used by many clinicians because of their unawareness of its beneficiary. In this study, we want to introduce and apply these scoring systems in our maxillofacial data, thus it can be used for documentation system, as a research tool, and have prediction value for prognosis We retrospectively collected data on patients with facial trauma in Cipto Mangunkusumo Hospital in 2009. The data collected were age, gender, etiology, use of helmet, type of fracture and treatment given. Each patient then evaluated by FISS score to obtain their degree of severity. Using FISS score introduced by Bagheri, we found the average FISS score ini this evaluation was 3,37 ± 1,9, with minimum value 1 and maximum value 9. Most patients have FISS score 2 (24,7%). From FISS scoring system, we found that most of maxillofacial trauma in Cipto Mangunkusumo hospital in 2009 was mild trauma. In order to evaluate if FISS scoring system has predictive value for prognosis, a large sample and complete maxillofacial database are needed.

Problems In Cleft Lip Nose Patients Undergoing Augmentation Rhinoplasty With Rib Graft : A Case Report Kusumastuti, Nadia; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 2 (2012): March Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Correction of a cleft lip nasal deformity remains a challenging procedure in reconstructive surgery. Many different procedures have been suggested to address the problem, but few techniques have worked well and consistently. We present a case of secondary cleft nasal deformity after repair of unilateral complete cleft lip and palate on the left side. The corrective procedures carried out included closed method rhinoplasty and dorsal nasal augmentation with rib graft which was fixed to the nasal septum with needle. The patient showed satisfactory immediate post-operative result, with correction of depressed alar base and satisfying dorsal and tip projection. However, 5 months post operative result showed deviation of nasal tip to the cleft side, which we suspected was due to: warping of the rib graft, soft tissue deficiency in the cleft side which exerts pulling forces to the warping graft, and lack of rigid fixation of the graft. After appraising pitfalls encountered in augmenting nasal dorsum of cleft patients with rib graft, we concluded that some preventive measures need to be done to avoid those problems, namely: balanced cross sectional carving of rib graft, cantilever graft with plate and screw to the nasal bone, and addressing pulling force from lack of soft tissue in the cleft side by adding columellar strut graft or alar contour graft.

Recurrent Cranial Bone and Scalp Defect : A Case Report Hakim, Intan Friscilla; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 2 (2012): March Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Partial defect of the cranial bone and scalp remains a dificult problem for surgeons. Longterm morbidity is due to dif!culty in finding the right material for closure and the resulting repeated surgery. This paper discusses the effectiveness of honey application as a simple and effective method for scalp defect treatment. One case of a patient with partial and cranium defect was referred to Cipto Mangunkusumo hospital with several prior attempt to close the defect with an acrylic implant. The cultured swab on patient revealed MRSA. Application of honey to the raw surface on the cranial defect shows resulting spontaneous epithelialization without clinical evidence of local infection. The use of honey as a topical treatment for cranial and scalp defect provide a safe and effective alternative method for closing the wound secondarily.

Self Made Nostril Retainer Raymond, Benni; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 2 (2012): March Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

The main feature of the unilateral cleft lip nasal deformity is the asymmetry of the nose compared with the non cleft side. Nasal stents or nostril retainers are suggested to be useful in the management of these patients in order to maintain the new morphology and to mold the shape during healing process. To date, there are many types of factory made nostril retainer, but the price is relatively expensive and in contrary, most of our patient came from low-income population. The idea is to provide an easy and practical nostril retainer to obtain, easy to manufacture and easy to apply preoperatively and postoperatively, and it is also cost effective. Primary nose model including the nasal cavity is designed on the basis of non cleft side of patient’s nose. It is made by injecting alginate as negative impression. We use gypsum powder as positive impression material. From that positive impression, we mirror it to create other side of the nostril. Nostril retainer is then made using home-use silicone gel. We postulate that by using self-made nostril retainer which is made using cheap material. All of our patients could afford one, because the use of nostril retainer has been found effective post operatively after cleft primary rhinoplasty, avoiding relapse of the nasal reconstruction and drop of the nasal ala.

Speech Outcome Evaluation After Two-Flap Palatoplasty In Plastic Surgery Division Cipto Mangunkusumo Hospital: A Retrospective study Bangun, Kristaninta; Handayani, Siti; Djoenaedi, Intania; Wahyuni, Luh Karunia
Jurnal Plastik Rekonstruksi Vol. 1 No. 2 (2012): March Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

One of the primary goal of cleft palate repair is to provide an intact mechanism for normal speech production. The purpose of this study is to evaluate the two-flap mucoperiosteal palatoplasty procedure on speech outcomes in patients undergoing surgical repair before the age of 2 years. A retrospective analysis study was done on 22 children with complete unilateral cleft palate (with or without cleft lip) who underwent two-flap palatoplasty between year 2002 to 2006 at Cipto Mangunkusumo Hospital. Evaluation was performed by a speech pathologist for pattern of articulation, hypernasality, intelligibility, and velopharyngeal competence. Palatoplasty were performed after 2 year-old in 11 patients and before 2 year-old in 11 patients. Speech of the 22 children postpalatoplasty was evaluated perceptually from standardised tape recordings. Velopharyngeal competence in patients who underwent palatoplasty before 2 year-old compared to after 2 year-old were 72.7% good, 18.2% fair and 9.1% poor versus 54,5% good, 9,1% fair and 36,4% poor respectively. Two-flaps mucoperiosteal palatoplasty performed before the age of 2 years old shows better spepolech outcome in all parameters, although the numbers are not statistically significant. Further prospective study with larger sample is needed.

The Simplest Modified Vacuum Assisted Closure to Treat Chronic Wound : Serial Case Report Mahandaru, Danu; Seswandhana, Rosadi
Jurnal Plastik Rekonstruksi Vol. 1 No. 2 (2012): March Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Among the current adjunctive treatment modalities available for the treatment of chronic wounds, vacuum-assisted closure therapy showed promising results. However, the VAC Therapy system is expensive, requires extensive amounts of product and needs a power source at all times. In this article, the authors introduce and review their experience with simplest modified vacuum assisted closure (smVAC) for treatment of chronic wound. Three patients with chronic wound came to the plastic surgery division at Sardjito hospital in early 2010 and were treated using simplest modified vacuum assisted closure (smVAC). After the wound bed was ready, split thickness skin graft (STSG) were performed to close the wound and smVAC was used to assist the graft placement. All patients underwent successful healing and reported satisfaction with their results. There were no side effects from using this device, such as maceration, necrosis and bleeding. Through the serial cases, the smVAC had shown to serve its function in providing adequate vacuum pressure for wounds. It is an alternative to the original vacuum assisted closure.

Synechia of Major Labia and It’s Operative Technique: A Case Report Samiadji, Muhammad; Pudjisriyani, Pudjisriyani; Swantari, Ni Made; Sukasah, Chaula L.
Jurnal Plastik Rekonstruksi Vol. 1 No. 2 (2012): March Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Labial synechia (labial fusion or labial adhesion) is a clinical entity rarely seen in adults. Labial synechia are usually caused by a combination of local inflammation, chronic infection and estrogen deficiency. This condition is not life threatening, but severe cases usually result in urinary problems.Methods: A case report based on the medical and surgical records was done. We found one case of labial synechia on a 65 years old female which was referred to plastic and reconstructive surgery department from the Gynecology department.Results: The reconstructive surgery was performed with two stage. Local anaestethic adhesiolysis as the first treatment then continued with general anesthesia reconstruction using both labial advancement flap to close the mucous defect. Patient was stay in the hospital in 5 days, and the flap to reconstruct the labia was vital.Conclusion: Multifactorial causes such as chronic infection, chronic inflammation, poor hygiene and history of systemic disease can be the etiology. Surgical approach is the best choice for this case because the synechia causes urinary problems.

Antibacterial Activity of Indonesian Local Honey Against Strains of P. Aeruginosa, S. Aureus and MRSA K. P., Ayu Diah; Sundoro, Ali; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 2 (2012): March Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Honey has been used in wound care since ancient times. Many publications attest antibacterial activity of manuka honey against Pseudomonas aeruginosa, S. aureus, and Methicillin-resistant S. aureus (MRSA). However, antibacterial effect of local honey from Indonesia has never been studied and compared to medical grade honey before. This study aim to compare antibacterial activity of local honey and manuka honey against P. aeruginosa, S. aureus and MRSA.Methods: The honeys were tested for their antimicrobial activities with broth dilution method. Different concentrations of honey were prepared in reaction tubes. Strains of P.aeruginosa, S. aureus, and MRSA were grown in nutrient broth. These strains of bacteria then added to the different concentrations of honey. Minimum Inhibitory Concentrations (MIC) is the lowest concentration of the honey that yielded no growth of bacteria.Results: MIC of local honey for P. aeruginosa is 50%, for S. aureus is 100% and for MRSA is 100%. MIC of manuka honey for P. aeruginosa is 12,5%, for S. aureus is 25%, and for MRSA is 12,5%.Conclusion: Nusantara Manuka have the similar antibacterial activity spectrum against P. aeruginosa, MRSA and S. aureus, but it must be given in greater concentration to exert the same level of antibacterial activity with Manuka honey.

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