Jurnal Plastik Rekonstruksi
ISSN / EISSN : 2089-6492 / 2089-9734
Current Publisher: Jurnal Plastik Rekonstruksi (10.14228)
Total articles ≅ 47
Latest articles in this journal
Jurnal Plastik Rekonstruksi, Volume 7, pp 51-58; doi:10.14228/jprjournal.v7i2.308
Introduction: Neglected fracture is a condition of fracture that is not handled or mishandled, resulting in a state of delay in treatment, or a worse condition and even a disability. The technical difficulty was associated with a greater incidence of complications and often lead to a suboptimal result. A more precise understanding of maxillofacial fracture's demographic patterns will help healthcare providers manage maxillofacial injuries. Method: Twenty-nine patients with neglected maxillofacial fractures were registered in the Division of Plastic Reconstructive and Aesthetic Surgery, Dr. Kariadi Central-General Hospital Semarang, January 2015 to December 2018. The collected information included gender, age, etiology, and site of fracture. Some of the cases are presented. Result: Neglected fracture of maxillofacial occurred predominantly in young adults. The male population was more frequently affected (62%)—most patients with neglected maxillofacial fractures associated with MVA (84%). The Mandible was the most common site of the fracture, followed by ZMC. Conclusion: The possibility of a fracture of Mandible and ZMC or adjacent bones should be considered in any facial trauma, especially related to MVA injury. Early and proper management will provide a better result.
Jurnal Plastik Rekonstruksi, Volume 7, pp 77-82; doi:10.14228/jprjournal.v7i2.286
Background: Burns is a type of trauma that requires treatment and rehabilitation, which is still difficult and requires perseverance, a high amount of costs, and trained and skilled personnel. Morbidity and mortality of burns are relatively high, especially in developing countries where burn prevention and treatment systems are inadequate. The prevalence of burns is expected to be an advantage for the development of science in further research and could help clinicians prevent and curative burn care efforts. Method: The study subjects were burned patients examined and hospitalized at Dr. Kariadi General Hospital, Semarang. Data from each sample's clinical examination results were then collected to be described based on gender, age, burns degree criteria, and etiology of burns. Results: The total sample obtained was 72 samples, including 61 patients (85.53%) with new burns and 11 non-emergency patients (14.47%). From a total of 61 new burn patients, eight female patients (13.11%) and 53 male patients (86.89%) were obtained; 10 patients (16.40%) were children (0-18 years), 50 (81.96%)were adults (18-65), and one patient (1.64%) belonged to geriatric (> 65 years) ); based on the degree of the burns, seven patients (11.48%) had a moderate degree and 54 patients (88.52%) had a severe degree; there were 28 patients (45.90%) who suffered burns caused by fire, 20 patients (32.79%) due to electricity, six patients (9.84%) caused by scald, and seven patients (11.47 %) with an unknown cause. Of the 61 new burn patients, there were five patients (8.20%) who died. Conclusion: Burn prevalence in Dr. Kariadi General Hospital, Semarang in 2012-2014 are mostly experienced by men, adults, with severe burn criteria, with the most common etiology is fire.
Jurnal Plastik Rekonstruksi, Volume 7, pp 44-50; doi:10.14228/jprjournal.v7i2.290
Introduction: Inhalational trauma is a significant cause of morbidity and mortality rates in burn patients. The high mortality rate for a burn with inhalation trauma requires a good understanding of the pathophysiology to provide comprehensive treatment.Method: Electronic literature searching of the MEDLINE (PubMed), Cochrane, and Google Scholar databases were conducted. Studies regarding inhalation trauma pathophysiology and its management that were eligible and available were chosen and used in this paper.Result: Inhalational trauma pathophysiology can be divided into three, namely damage to the upper respiratory tract, lower respiratory tract, and systemic toxicity. Management can be divided based on post-exposure early management (0-72 hours) and advanced management (3-21 days).Conclusion: At present, the management of inhalation trauma is still moderately supportive. Further research based on inhalation trauma pathophysiology is still needed for effective management so that later it can reduce the morbidity and mortality rates.
Jurnal Plastik Rekonstruksi, Volume 7, pp 59-64; doi:10.14228/jprjournal.v7i2.281
Background: The epidemiology pattern of patients with burn injury varies widely in different parts of the world. This study aimed to identify epidemiological data from hospitalized burn injury patients in Zainoel Abidin General Hospital, a referral Hospital in Aceh. Methods: All hospitalized burn injury patient data from January 2016 to December 2017 were collected from the medical record. Data taken included Gender, age, length of stay (LOS), mortality, severity, and extent of the burn, and etiology of burn. Results: From all hospitalized patients with burn injury, the male to female ratio is 1,6:0,9. The mortality rate is 9%, while the others survive. From all etiology of burn, 57% is flame injury, 19% is electrical injury, 18% is scald burn injury, 4% is contact burn injury, and 1% is a chemical burn injury. No patient with first-degree burns was hospitalized, while 13 patients had third-degree burn injuries, and the rest had second-degree burn injuries. Conclusion: An increasing number of hospitalized patients from 2016 to 2017, from 25 patients to 42 patients. It might happen because of increasing knowledge about burn injury in society and physicians in rural areas to refer patients to the hospital with better facilities.
Jurnal Plastik Rekonstruksi, Volume 7, pp 65-76; doi:10.14228/jprjournal.v7i2.285
Background: Burns is a severe public health problem. Its poor treatment can lead to the worst complication called sepsis. Since sepsis decreases the immune system, the critical therapy management of burn sepsis ensures adequate end-organ perfusion. According to the Surviving Sepsis Campaign Bundle, immediate identification and management in the initial hours generate a better outcome. The inflammation of burn injury is known to increase ROS production, which causes cellular damage, sepsis, and MODS. This condition initiates the importance of ROS scavenger. Methods: This literature reviewed from relevant works of literature which searched from major journal databases of WHO, Pubmed, Elsevier, JAMA, Springer, NEJM, which published from 2013 until 2018 Results: Vitamin C is a cheap but effective antioxidant, which acts as a ROS scavenger and reduces the fluid requirement in burn resuscitation for the prevention of burn sepsis Conclusion: Vitamin C could be recommended as adjuvant therapy in the prevention of burn sepsis
Jurnal Plastik Rekonstruksi, Volume 7, pp 35-43; doi:10.14228/jpr.v7i1.291
Introduction: Pressure ulcer (PU) is a result of prolonged pressure and shear over a bony prominence resulting in tissue injury of varying depth. To date, there is no standardized wound dressings for PU. Due to its availability and affordability, honey is suitable as PU wound dressing considering its anti-oxidant, anti-inflammatory, and antibacterial properties. This review article will provide evidence of the superiority of honey dressing.Methods: Literature source was searched through online databases with relevant keywords and then appraised for their validity, importance, and applicability. Total of three articles were appraised.Results: All articles agreed that application of honey on PU wounds reduced wound size and alleviate pain. Honey-impregnated gauze dressing promoted faster pain relief throughout treatment and less discomfort during each dressing change. Healing rate was proven 4 times faster with honey compared to other topical ointments. However, the antibacterial effect of honey was not significantly confirmed in the study. Nonetheless, topical application of honey successfully accelerates wound healing in PU.Conclusion: Honey is a promising alternative for topical dressings in patients with PU.
Jurnal Plastik Rekonstruksi, Volume 7, pp 38-42; doi:10.14228/jpr.v7i1.298
Introduction: Multi-stages refinement of a bulky flap after composite defects reconstruction of multiple facial units has been a challenging situation. Goals including restoration of periorbital and malar area and redefining the aesthetic aspects of the units as well as the surrounding nasolabial area with multiple refinements and microfat graft. Methods: A 50-year-old male patient with a history of solitary fibrous tumor underwent wide excision of left periorbital, infraorbital, lateral nasal sidewall, and malar area. The defect is enclosed with Anterolateral Thigh Free Flap (ALT). Bulkiness of the flap, sunken left nasolabial, and asymmetric alar nasal unit were found during outpatient follow-up. These problems lead to the necessity of refinement procedure to reduce the bulkiness to improve the aesthetic outcome of the patient. Microfat graft was the method chosen to volumized the sunken nasolabial and asymmetric alar nasal unit. Results: Patient is satisfied with the result due to improvement of alar nasal units symmetricity and reduced bulkiness of the flap area. No complication was observed. Conclusion: Meticulous planning and staging of the surgical refinement procedures in conjunction with microfat graft results in good aesthetic outcome and satisfies the patient and reduces the possibility of complications.
Jurnal Plastik Rekonstruksi, Volume 7, pp 28-34; doi:10.14228/jpr.v7i1.280
Introduction: Burn injury is one of the leading causes of morbidity and mortality in low and middle-income countries. Yet in Indonesia, the epidemiology of burn is rarely reported. The study aims to obtain the epidemiological characteristics of burn patients in Dr. Iskak General Hospital. Methods: A retrospective analysis study was used and the medical records of patients with burns admitted at Dr. Iskak General Hospital between January 2017 and December 2018 were collected and analyzed statistically. Results: A total of 80 patients were involved in this study. The most burn victims fell in the adult group (>18 years old), which was 56.3% (n=45). Children were six times more likely to sustain scald burn than adults (OR=6.75I; CI95% 2.47-18.41), meanwhile adults were three times more likely to sustain flame burn than children (OR=3.643; CI95% 1.186-11.190). Most of burn patients (91.25%) were treated surgically. The median of hospital stay was 8 days. Flame burn was the primary etiology for longer hospitalization and there was zero mortality in this study. Conclusion: We found that the adult group was at the highest risk of acquiring burns. Scald was the major cause of burns in children, while flame was the main etiology in the adult group that caused severe burn and prolonged hospitalization.
Jurnal Plastik Rekonstruksi, Volume 7, pp 18-28; doi:10.14228/jpr.v7i1.292
Summary: Severe burns are devastating condition identified by loss of hemodynamic stability and intravascular volume. Adequate fluid replacement, nutritional support, and immediate wound grafting can reduce the risk of infection and mortality. Oxidative stress was shown to have significant role in the burn wound conversion, which happens when the zone of stasis can’t be salvaged and progresses to necrosis. Decreasing the level of oxidative stress early may be fundamental in reducing burn injury progression into deeper tissue. Several animal studies have demonstrated the advance of antioxidant supplementation for burns outcomes. Approach to this salvageable burn tissue is a breakthrough for new directions in burn management. Antioxidant supplementations was proven to prevent burn conversion on the ischemic zone. Administering antioxidant post-burn is linked with less progression of burn depth and inflammatory cytokine release, which alleviates burn-related morbidity and mortality and improves patient’s quality of life. To date, no clinical trials have been done to reproduce similar outcomes of this ROS-scavenging therapy as successfully observed in murine models. Antioxidant supplementation is a promising treatment avenue to halt burn wound conversion following severe burns. Keywords: Burn wound, wound conversion, burn management, antioxidant
Jurnal Plastik Rekonstruksi, Volume 7, pp 10-17; doi:10.14228/jpr.v7i1.278
Summary: The concept of tissue engineering has now been accounted for one of the most prospective answers to the growing needs of tissue and organ replacements. Many studies and researches are continuously done to achieve a paramount strategy in tissue engineering and regenerative medicine. This review emphasizes the concept, strategies, current application, and current challenges in tissue engineering. The strategy in tissue engineering has much improved and successfully applied in several reconstructive cases. Understanding of isolated cells’ behaviors, materials suitable for its’ scaffolds, in adjuncts with specific growth-inducing factors for each specific tissue or organ built is the key for successful tissue engineering. Ringkasan: Konsep tissue engineering merupakan salah satu jawaban yang paling diharapkan dapat memenuhi kebutuhan pengganti jaringan dan organ yang terus meningkat pada saat ini. Beragam studi dan penelitian secara terus-menerus dilakukan agar dapat memperoleh strategi terbaik dalam tissue engineering dan regenerative medicine. Artikel ini berfokus pada konsep, strategi, aplikasi terkini, dan tantangan di masa mendatang pada tissue engineering. Strategi tissue engineering telah banyak berkembangan dan berhasil diterapkan pada kasus-kasus rekonstruksi. Pemahaman mengenai perilaku sel, kecocokan material dengan scaffolds, serta faktor pendukung pertumbuhan untuk masing-masing jaringan atau organ spesifik yang akan diciptakan merupakan kunci keberhasian tissue engineering.