Jurnal Plastik Rekonstruksi
ISSN / EISSN : 20896492 / 20899734
Current Publisher: Jurnal Plastik Rekonstruksi (10.14228)
Total articles ≅ 45
Latest articles in this journal
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 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 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.
Jurnal Plastik Rekonstruksi, Volume 7, pp 4-6; doi:10.14228/jpr.v7i1.295
Summary: Free fibular flap (FFF) is a composite flap consisting of fibular bone and skin paddle. Muscle may be added to the flap. It has several advantages and disadvantages. The fibular free flap is well suited for any reconstruction of the head and neck. It is suitable for defects of the anterior mandibular arch or lateral defects in patients who wish to undergo osseointegrated dental reconstruction. Meanwhile, its contraindications are related to significant atherosclerotic diseases the patient has or congenital variants of the arteries. Preparations for FFF procedure consist of history taking, physical examinations and supporting examinations, like other free flaps procedure in general. Several intraoperative preparations should also be done.
Jurnal Plastik Rekonstruksi, Volume 7, pp 7-9; doi:10.14228/jpr.v7i1.296
Summary: Radial forearm flap is fasciocutaneous flap from the volar aspect of the forearm that based on the perforator of radial artery. Radial forearm free flap (RFFF) has several advantages and disadvantages. It has unique characteristic of thin and pliable tissue. It may be indicated when a defect requires a thin flap with little bulk of soft tissue or multiple skin islands are needed to be provided. Physical signs and symptoms of poor peripheral digit perfusion or healing contraindicate the harvest of the radial artery pedicle. Preparations for RFFF procedure include history taking, physical examinations and supporting examinations. Several steps of intraoperative preparations should also be conducted.
Jurnal Plastik Rekonstruksi, Volume 7, pp 1-3; doi:10.14228/jpr.v7i1.294
Summary: The anterolateral thigh (ALT) flap is the flap with various components based on perforators from the descending branch of the lateral circumflex femoral artery. This flap has a number of advantages and disadvantages. It can be used to reconstruct defects after oncologic resection and coverage following amputation or to preserve limb length. The contraindications include unsuitable donor sites, inadequately debrided recipient sites, and morbid obesity. Preparations for ALT procedure consist of history taking, physical examinations, and supporting examinations.
Jurnal Plastik Rekonstruksi, Volume 6, pp 281-290; doi:10.14228/jpr.v6i2.288
Plastic surgery in Indonesia was pioneered and developed by Moenadjat Wiratmadja, MD., in 1958. This specialty experienced many developments and improvements over time with more specific subspecialties to facilitate the advancement of the science of plastic surgery, including the reconstructive microsurgery subspecialty. The reconstructive microsurgery service in the plastic surgery division dr. Ciptomangunkusumo National Hospital (RSCM), Jakarta, Indonesia was first initiated by Sidik Setiamiharja, MD., self-taught from the textbooks. In late 1985, following the success of conducting the first basic microsurgery course in Jakarta, the plastic surgery team in RSCM which consisted of Sidik Setiamihardja, MD, Chaula L. Sukasah, MD and Gentur Sudjatmiko, M.D. pioneered many of the first microsurgery cases, including the first major limb replantation, first penile replantation and the first free flap. Overtime, the reconstructive microsurgery subspecialty has been growing significantly. In 2019, the number of free flap cases at RSCM reached the highest number in Indonesia with 90 free flap cases with 94% success rate.
Jurnal Plastik Rekonstruksi, Volume 6, pp 270-275; doi:10.14228/jpr.v6i2.284
Background : Good formation of granulation tissue in the ulcer bed is regarded as one of the indicators of pressure ulcer healing. Granulation red index (GRI) had been published as an objective parameter to assess the quality of granulation tissue. Honey stimulates granulation of tissue and creates a moist healing environment. However, the assessment of granulation tissue quality of pressure ulcers treated by honey has yet to be proven in clinical settings. In this study, we evaluate the granulation tissue quality of pressure ulcers treated by honey using granulation red index by digital image analyses. Method: There were 12 subjects who fulfill inclusion criteria treated by honey gauze dressing and were evaluated every week for three times measurements of %GRI and DESIGN-‐score. Parameters of this study were the delta %GRI80 and DESIGN-‐R score. Correlations were evaluated by Spearman’s correlation coefficient. Result : The correlation of delta GRI80% and DESIGN-‐R score was statistically significant from baseline measurement to first week of treatment and to second week of treatment (r1=0.65, p1=0.02 and r3=0.832, p2=0.001). The correlation of delta GRI80% and DESIGN-‐R score from first to second week therapy was not statistically significant (r=0.23, p=0.47), but the GRI80% from first week therapy to second week of therapy was increasing and DESIGN R score was decreasing. Conclusion:This study shows the correlation of %GRI80 and DESIGN-‐R score of pressure ulcer after the treatment of honey gauze dressing. This study hopefully assists further study for wound bed preparation assessment and treatment of pressure ulcer for surgical intervention.