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Jurnal Plastik Rekonstruksi

jpr
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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.

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Articles 211 Documents

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Modalities to Treat Penile Glans Amputation: Case Series Sukasah, Chaula L.; Atmodiwirjo, Parintosa; Anindhawati, Nur
Jurnal Plastik Rekonstruksi Vol. 1 No. 4 (2012): July Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: In Indonesia, a country with Muslim population as a majority, circumcision is the most common operation performed in males. However, since circumcisions are also commonly performed by inexperienced individuals and during communal circumcision event, we frequently come across complications. One of the most severe complications is amputation of the penile glans. There are several techniques that can be used to treat this complication. In this paper we present some which have been used in our division and the result. Patient and Methods: We report three cases of traumatic penile glans amputation as a complication of circumcision that has been admitted to Cipto Mangunkusumo Hospital during January 2011 – January 2012. In first case we performed full thickness skin graft, in the second one we performed groin flap, and scrotal flap to reconstruct the third case. We evaluate the result for several months. Results: The three techniques showed no complication, good result in function and also aesthetically acceptable for patient and the family. Choice of technique that has been used to repair the amputated penis depended on the patient condition, and surgeon’s choice.Summary: The three techniques each has advantages and disadvantages, but all of them are acceptable, functionally and aesthetically.

Comparison of Wound-bed Preparation Time in Chronic Traumatic Wound Using Topical Honey Application and Conventional Dressing Mukarramah, Dewi A.; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 4 (2012): July Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Background: Prior to the de!nitive closure of wound by skin graft, it is essential for the recipient wound to be prepared adequately. Honey has been shown to exert a valuable effect in wound healing, atributale to its six favorable characteristics. This clinical study is proposed to determine the effectiveness of a specific sample honey (Madu Nusantara®) in accelarating the time of wound bed preparation in chronic traumatic wound.Methods: A randomized non-blinded clinical trial was done on patients with chronic traumatic wound who required wound bed preparation before definitive closure, during a one-year period. A total of 18 patients were included in the study, divided into two interventions. One has wound treated by topical application of honey (HDR), and controls were treated by conventional dressing (CDR). Daily wound treatment and evaluation was done using The Bates-Jensen Wound Assesment Tool until wound-bed was ready to be skin-grafted. The time required until wounds were ready to be grafted was also measured in both groups.Results: The mean time of wound bed preparation in HDR gorup was 12 days (n=11), and 26 days in CDR group(n=7, p 0.0055). The mean Bates-Jensen score of HDR improved from 45.45 before treatment to 23.36, versus 44.00 to 29.00 in CDR subjects.Conclusion: A favorable wound bed is essential prior to skin grafting.Our data shows that topical application of honey is more effective in accelerating the time of wound bed preparation than conventional dressing in patients with chronic traumatic wound.

Early Detection of Elevated Serum Procalcitonin Is Required as Warning Sign of Sepsis in Burn Patients Fortuna, Fory; Wardhana, Aditya
Jurnal Plastik Rekonstruksi Vol. 1 No. 4 (2012): July Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Backgrounds: Procalcitonin (PCT) is a marker of the inflammatory response. This biomarker also plays a key role in burn injury, as it is accompanied by systemic inflammatory response syndrome (SIRS). Elevated level of serum PCT possibly interprets the state of inflammation and multiple organ dysfunctions (MOD) with the risk of lethal outcome.Patients and Methods: We detected high serum PCT level associated with its warning state of inflammation in 3 adult patients. We found that each high PCT level was continued by its state of inflammation. These four patients encounter serum PCT level into more than 10 ng/ml. Sepsis was diagnosed according to American Burn Association Sepsis Criteria.Results: High elevated PCT serum level (161.70 ng/mL) was detected on the first patient 8 days post burn injuryand died on the next 5 days. on the second patient, high PCT serum level (40.81 ng/mL) detected 9 days after burn injury and died on the next 2 days. The third patient was detected with high PCT serum level (12.28ng/mL) 2 days after burn injury was died on the next 2 days. The pediatric patient was detected with high PCT level (23.41 ng/ml)11 days after burn injury and died on the next 4 days.Summary: We found that it is important to initiate PCT measurements in burn patients at the time of admission. Daily measurement of PCT levels is needed for an early diagnosis and treatment of burn sepsis, monitoring therapy and MOD prevention.

Dear Plastic Surgeons, Do Not Pull Away From Hypospadias Chaula L. Sukasah
Jurnal Plastik Rekonstruksi Vol. 1 No. 1 (2012): January Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jpr.v1i1.93

Hypospadiology is plastic surgery

Our Appreciation Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 1 (2012): January Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jpr.v1i1.95

May wellbeing, compassion, and abundance be blessed upon us always

Curettage and Policresulen Tampon as A Modality Treatment in Management of Verucca Simamora, Huntal; Lestari, Puri Ambar; Bangun, Kristaninta; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 5 (2012): September Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

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.

Management of Patient with Closed Degloving in the Pelvic Region: a Case Series Atmadja, Tessa Miranda; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 5 (2012): September Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

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.

Therapy For Unilateral Lower Extremity Lymphedema With Compression Bandage Only Or Compression Bandage Combined With Surgery Hakim, Intan Frischilla; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 5 (2012): September Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

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.

Chimeric Flap for Reconstruction of Severe Traumatic Injuries of the Hand (a Case Report) Atmodiwirjo, Parintosa; Harihadi, Eko
Jurnal Plastik Rekonstruksi Vol. 1 No. 5 (2012): September Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

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.

Accelerated Healing of The Wider Lateral Defects in Adult Cleft Palate Repairs Mukarramah, Dewi Aisyah; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol. 1 No. 5 (2012): September Issue
Publisher : Lingkar Studi Bedah Plastik Foundation

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.

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