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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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Multidisciplinary Approach in Treating Undiagnosed Severe Temporo Mandibular Joint Ankylosis : A Case Report Sandhi, Afriyanti; Pakpahan, Evie Lamtiur; Handayani, Siti; Bangun, Kristaninta
Jurnal Plastik Rekonstruksi Vol. 1 No. 3 (2012): May Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Temporo Mandibular Joint (TMJ) ankylosis refers to bone or fibrous adhesion of the anatomic joint component and the ensuing loss of their function. The TMJ forms the very cornerstone of craniofacial integrity and hence its ankylosis in growing children adversely affects the growth and development of the jaws and occlusion. Difficulty in mouth opening and mastication, poor oral hygiene and rampant caries pose a severe physical and psychological burden in the tender minds of children. Patient and Method: Bony ankylosis on the right TMJ in a female patient was not diagnosed until the patient reached her early teens, at which the condition was treated by bony fusion release on the right condyle. We managed the patient for further orthognathic surgery (Le Fort I Ostoeotomy and Bilateral Sagittal Split Osteotomy) to correct the skeletal deformity. Result: In collaboration with the Orthodontist for pre-surgery and post-surgery orthodontic treatment, and Physiotherapist for mouth opening and masticatory muscles exercises, a good functional and aesthetic result was achieved. Summary: Multidisciplinary approach in treating severe TMJ ankylosis is mandatory to achieve the optimum results. Awareness among all plastic surgeon and dentist involved in the treatment of craniofacial pathologies in children must be build to allow early diagnosis and treatment.

The Correction of The Auricle in Neurofibroma with Aggressive Tumor Removal Principle and Two Stages Total Ear Reconstruction Bangun, Kristaninta; Chen, Zung Chung
Jurnal Plastik Rekonstruksi Vol. 1 No. 3 (2012): May Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Neurofibroma is a major facial hamartoma and is one of the most destructive and debilitating disease affecting the skin, muscle, mucosa, and the skeletal systems. Involvement of the ear usually increases the dimensions of the auricular skin and underlying tissues, distorts normal architecture along with auricular malpositioning, producing an ear that is abnormal in size, shape and position. The correction of the auricle in neurofibroma and benign tumors of the head and neck has been reported, but overall favorable results appear difficult to attain. We present a case of neurofibroma of the auricle in which radical resection was performed, and reconstruction was done in a two-stage surgery with satisfactory result. Patient and Methods: A 30 years-old female presented with type-1 neurofibroma to our office, especially concerned of a large tumor growth on the right auricle. With prior experience in treating microtia cases by Nagata’s method, we performed a two-stage operation on the patient. The first operation involved excising the whole auricular mass, and fabricating as well as grafting of a three-dimensional costal cartilage framework. In the second stage, the ear was elevated.Result: Nine months after the second surgery, the result was satisfactory with good auricular definition attained, and proper elevation of the ear at the correct anatomical site. No sign of neurofibroma recurrence was found on the surrounding reconstructed auricle.Summary: In our experience, the correction Neurofibroma of the ear by using the aggressive tumor removal principle combined with Nagata’s two-stage total ear reconstruction delivered a satisfactory result.

The Non-denuded Mucoperiosteal Palatoplasty Technique in Precipitating Healing Process of Palatal Lateral Defect Irwansyah, Denny; Bangun, Kristaninta; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 3 (2012): May Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Conventional two-flap palatoplasty technique which is a very common technique used including in our center, will result in lateral defects without any periosteal coverage. In this conventional technique, epithelialization of lateral defect was achieved within 3-4 weeks. These denuded lateral defects are prone to contamination and infection. The wound healing process in these wound will involve wound contraction, trigger scar formation, and will result in maxillary growth impairment. In our center, the retrospective study showed that conventional two-flap palatoplasty technique resulted in a fair maxillary growth (mean Goslon score=3.5). Thus, we explore other technique, which is non-denuded mucoperiosteal palatoplasty technique. We intend not to elevate all layers of mucoperiosteal flap in order to gain lateral defect covered by a thin sub-mucosa and periosteal layer. We assume that this technique will precipitate the re-epithelialization process. Faster re-epithelialization is expected to decrease wound contraction thus reducing scar formation, and in the long run will result in good maxillary growth. Method: Total 48 patients with unilateral or bilateral cleft palate were divided into 2 groups. Twenty-four patients underwent the non-denuded mucoperiosteal technique (intervention group) and another 24 patients underwent the conventional two-flap palatoplasty technique (control group). Evaluation of lateral defect closure was done in both groups and compared statistically. Result: Faster epithelialization was significantly influenced by age, WBC count and non-denuded mucoperiosteal technique.Summary: The non-denuded mucoperiosteal technique, along with age and WBC count, significantly accelerate the process of epithelialization of lateral defect post palate repair.

Penile Reconstruction of Congenital Urogenital Malformation: Penile Duplication, Bifid Scrotum, Symphisiolysis, and Remnant Urachus Harsono, Anastasia Dessy; Budiman, Budiman; Sukasah, Chaula Luthfia
Jurnal Plastik Rekonstruksi Vol. 1 No. 3 (2012): May Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: This report describes the penile reconstruction of a congenital urogenital malformation.Patient and Method: A 12 year-old boy came to our hospital with ‘penile duplication’, bifid scrotum, symphisiolysis, and remnant urachus. The procedures were done by the urologist, pediatric surgeon, and plastic surgeon. Urethral evaluation done by the urologist determined which penis was tenable, pediatric surgeon then excised the remnant urachus, and we performed urethroplasty onto the chosen urethra. The medial side of the penis was deepithelialized and both penis were put within one skin covering.Results: Patient was able to control micturition, and has normal erectile function. In the future, we plan to do further reconstruction of the pubic symphisiolysis at pubertal age.Summary: Surgery was performed by a team dedicated to their specialties. There is no single standard procedure for urogenital malformation, and we must emphasize the functional and aesthetic results in reconstruction surgery. It is important to master the basic principles of plastic surgery.

Hypospadic Cripple: How To Avoid Bisono, Bisono
Jurnal Plastik Rekonstruksi Vol. 1 No. 3 (2012): May Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

The term hypospadic cripple is very apt to use for hypospadic patient who has underwent several unsuccessful reconstruction attempt. The meaning of the word cripple is uncapable to function properly. If it is used for condition after failure of several attempt of reconstructions in hypospadia repair, the meaning of severe damage should apply; a crippled penis with fistula, stricture, contracture and less healthy skin cover.

Application of Honey and Transparent Dressing to Split Thickness Skin Graft Donor Site and Its Effect on Epithelialization Rate A., Teuku; P., Nandita Melati; Sudjatmiko, Gentur; S., Asrofi; D., Ishandono
Jurnal Plastik Rekonstruksi Vol. 1 No. 3 (2012): May Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Split thickness skin graft (STSG) is one of the modalities used to close a defect. The donor site can be healed secondarily with tulle grass and moist gauze after 14 days and with transparent dressing will take about 10-13 days. Recently the wound healing by using honey application has been used. Whether or not using honey application with transparent dressing will hasten the epithelialization rate of the STSG donor site is now in question. Method: This research is an open, non-randomized clinical trial with a parallel design and intervention using honey application with transparent dressing. A total of 19 patients (7 female and 8 male) were included in this study. The reapplication of honey was done every two days. The patients was followed up every day, with clinical photograph taken and complaints such as pain, odor and infection noted. Results: The mean epithelialization rate of the donor site treated with honey and transparent dressing was 9,74 (+0,24) days compared to 10,79 (+1,23) days in the transparent-dressing-only group (p=0,00). Conclusion: The application of honey with transparent dressing to cover for STSG donor site led to a faster epithelialization rate, less odor and less pain. Commercial honey was used, and readily available.

Comparison of Physical–Chemical Characteristic and Antibacterial Effect Between Manuka Honey and Local Honey Sundoro, Ali; K., Nadia; A., Nur; Sudjatmiko, Gentur; Tedjo, A.
Jurnal Plastik Rekonstruksi Vol. 1 No. 3 (2012): May Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background:Honey has positive effects on wound healing due to its properties to decrease inflammatory reaction, assist wound debridement, lessen wound odor, help moisturize the wound, promote wound healing and has antibacterial effect. In this research we try to confirm the benefit of using Indonesian local honey by comparing its efficacy with Manuka honey, which is already known yet still costly and not readily available in Indonesia.Methods: Two kinds of honey above were compared for its physical and chemical properties of antibacterial effects and safety, its acidity (pH) using pH meter, osmotic pressure with indirect measurement using hygroscope and hydrogen peroxide concentration using hydrogen peroxide strip test, also for its bacterial contents using standardized microbiological culture.Results: The measurements of the water activity, pH level,production of hydrogen peroxide, also the bacterial content, showed that there is no significant difference between the manuka honey and the local ones.Discussion: Both of the honey pH levels are still within the normal range of honey pH level (3.5-4.5) which still have the antibacterial properties to inhibit bacterial growth. Both of the honey water activity level are still within the normal range of honey water activity level (0.500–0.650) which still have the antibacterial properties to inhibit bacterial growth. Manuka honey has been known as non peroxide honey that didn’t produce any hydrogen peroxide.Conclusion:Indonesian local honey which has been used in this research has a similar physical–chemical characteristic as Manuka honey; making it a very good alternative source of medicinal honey because of its affordability and availability.

The Effect of Honey on Granulating Tissue of The Mandibular Bone Harsono, Anastasia Dessy; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 3 (2012): May Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: For many years, ancient civilizations used honey to heal wounds. Rediscovery of honey by modern physicians its use in conventional medicine. Few detailed descriptions of honey in healing difficult surgical wounds have been previously published.Methods: We report patient, male, 16 years old, who suffered acute lymphocytic leukemia and extensive mandibular eschar and had presented half of mandible bone exposed after escharectomy. Given the of closing the defect due to poor general condition of the patient, we advocated to applicate honey dressing on mandible bone to promote granulation tissue, to prevent infection and to promote epithelialization.Results: Due to honey’s effect are anti inflammatory and antimicrobial activity, promotes debridement, reduces malodor, maintains moist wound environment, and stimulates healing, in a month, all mandible exposed had been covered by granulation tissue, followed by skin grafting.Conclusion: In this case, honey had been proven effectively to stimulate granulation tissue growth on mandible bone both before and after surgery.

Nosocomial Infection in Burn Unit of Cipto Mangunkusumo Hospital, Jakarta Mahandaru, Danu; Wardhana, Aditya
Jurnal Plastik Rekonstruksi Vol. 1 No. 3 (2012): May Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Backgrounds: Burn patients, due to the immune compromise effects of their injury have a high risk for infections. The major cause of infection is the hospital environment contamination. This study was conducted to detect and identify isolated bacteria from patients and hospital environment in the Burn Unit and determine their antibiotics pattern in response to commonly used antimicrobial agents; in order to give recommendations for management of bacterial infections and drug-resistance. Patients and Methods: Retrospective observational study was conducted reviewing the database of Burn Unit in RSCM from January until December 2010. The characteristics of microorganisms found on the burn wound were compared to those obtained from the environments such as from the air, bathing water, and medical instruments. The pattern of microorganisms and their sensitivity-resistance characteristics were noted.Result: The pattern shows that nosocomial infection in the Burn Unit of RSCM was high. Klebsiella pneumoniae found on the burn wound eschars mimics those obtained from the air within the Burn Unit. Strains of MRSA were also found on screening.Conclusion: Our findings emphasize the need for careful disinfection and more strict infection control procedures in areas that serve immune suppression individual, such as burn patients.

The Effects of Wireless Micro Current Stimulation for Partial Thickness Burn Injury Treatment Utama, Defry; Wardhana, Aditya
Jurnal Plastik Rekonstruksi Vol. 1 No. 3 (2012): May Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Backgrounds: The body has its own bioelectric system that influences wound healing. Wireless Micro Current Stimulation (WMCS) or Electrical Stimulation (ES) is defined as the use of an electrical current to transfer energy to a wound. The type of electricity transferred is controlled by the electrical source. Although scarce, there have been studies proposing that this type of electricity increased healing rate of various wounds. However the effect of this electrical stimulation on burn wounds has not yet been studied.Patient and Methods: We present case series of superficial and deep partial thickness burns treated with ES and examine its effect on healing process. Six cases of second degree burn admitted to Cipto Mangunkusumo General Hospital (RSCM) from March–May 2011. They were chosen randomly to be treated with WMCS/ES. We applied the stimulation on the wound one hour daily. The wound was cleansed conventionally with moist gauze before and after the stimulation.Results: All the patients reported that they feel comfort during and after the application. We found epithelialization within 6 to 9 days. However we cannot determined if the WCMS/ES induce faster wound healing, because we do not compare it with other treatment. Summary: From six cases that we studied, we concluded that, the use of this WCMS/ES could have an effect of the epithelialization within 6-9 days. All the patients reported that they feel comfort during and after the application of WMCS/ES.

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