Pub Date : 2023-01-30DOI: 10.14228/jprjournal.v9i2.347
Mohamad Rachadian Ramadan, P. Atmodiwirjo, Amila Tikyayala
Background: Central facial soft tissue defect poses a unique challenge for the reconstructive surgeon. The three-dimensional properties of the aesthetic facial subunit and its related function are the goals for reconstruction. Considering the prominent social role of the face, the procedure to achieve a good quality of life for patients may cost more than a single surgery. This single-center study presents an algorithm of treatment for central facial soft tissue defect and it’s proposed classification according to the authors’ experiences. Methods: A retrospective review of medical records and photos of patients who underwent central facial soft tissue defect reconstruction in Cipto Mangunkusumo National Hospital, Jakarta, Indonesia, from 2009 to 2019. Patients who underwent free flap reconstruction were followed up, and the primary outcomes were assessed using the FACE-Q head and neck cancer (FACE-Q H&N) scale. A classification system for central facial soft tissue defect with seven subtypes (1–7) based on the facial subunit and its treatment was proposed. Results: Twenty-five patients were included. The malignant tumor was the main etiology (88%), with basal cell carcinoma being the primary cancer pathology (64%). The average defect size was 120 cm2 (32-416 cm2) and most defects fell into subtype 6 of the classification (32%). Anterolateral thigh free flap (ALT) was the main flap of choice (64%), followed by radial forearm free flap (36%), with 92% of flaps succeeding rate from this series. All of the patients underwent at least one ancillary procedure following the reconstruction, while the average was 2 (1-6) procedures. FACE-Q H&N outcomes, especially on the appearance and appearance distress scale, showed a low to moderate score with a 72% response rate. Conclusions: Central facial soft-tissue defect continues to challenge reconstructive surgeons. While the advances in free tissue transfer might improve the general outcomes, the numerous and costly secondary procedures do not usually end up in the best appearance. This study displayed the need for modern reconstruction modalities that provide high satisfaction in aesthetic and functional outcomes with fewer secondary procedures. Vascularized Composite Allotransplantation (VCAT) might be the future choice.
{"title":"Central Facial Soft-Tissue Defect Following Surgical Resection: An Algorithm for Reconstruction","authors":"Mohamad Rachadian Ramadan, P. Atmodiwirjo, Amila Tikyayala","doi":"10.14228/jprjournal.v9i2.347","DOIUrl":"https://doi.org/10.14228/jprjournal.v9i2.347","url":null,"abstract":"Background: Central facial soft tissue defect poses a unique challenge for the reconstructive surgeon. The three-dimensional properties of the aesthetic facial subunit and its related function are the goals for reconstruction. Considering the prominent social role of the face, the procedure to achieve a good quality of life for patients may cost more than a single surgery. This single-center study presents an algorithm of treatment for central facial soft tissue defect and it’s proposed classification according to the authors’ experiences.\u0000Methods: A retrospective review of medical records and photos of patients who underwent central facial soft tissue defect reconstruction in Cipto Mangunkusumo National Hospital, Jakarta, Indonesia, from 2009 to 2019. Patients who underwent free flap reconstruction were followed up, and the primary outcomes were assessed using the FACE-Q head and neck cancer (FACE-Q H&N) scale. A classification system for central facial soft tissue defect with seven subtypes (1–7) based on the facial subunit and its treatment was proposed.\u0000Results: Twenty-five patients were included. The malignant tumor was the main etiology (88%), with basal cell carcinoma being the primary cancer pathology (64%). The average defect size was 120 cm2 (32-416 cm2) and most defects fell into subtype 6 of the classification (32%). Anterolateral thigh free flap (ALT) was the main flap of choice (64%), followed by radial forearm free flap (36%), with 92% of flaps succeeding rate from this series. All of the patients underwent at least one ancillary procedure following the reconstruction, while the average was 2 (1-6) procedures. FACE-Q H&N outcomes, especially on the appearance and appearance distress scale, showed a low to moderate score with a 72% response rate.\u0000Conclusions: Central facial soft-tissue defect continues to challenge reconstructive surgeons. While the advances in free tissue transfer might improve the general outcomes, the numerous and costly secondary procedures do not usually end up in the best appearance. This study displayed the need for modern reconstruction modalities that provide high satisfaction in aesthetic and functional outcomes with fewer secondary procedures. Vascularized Composite Allotransplantation (VCAT) might be the future choice.","PeriodicalId":364477,"journal":{"name":"Jurnal Plastik Rekonstruksi","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129369944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-07DOI: 10.14228/jprjournal.v9i1.337
K. Bangun, J. Halim, V. Tania
Background : The techniques of cleft palate repair has faced significant evolutions. More importantly, no surgical protocol has been significantly associated with lower incidence of post-operative complications such as fistula formation, velopharyngeal insufficiency, or speech hypernasality. As cleft width is a strong predictor of outcomes, The Lima Protocol was introduced to select suitable surgical technique based on the degree of severity measured by palatal index. This article aimed to evaluate the efficacy of the newly established Lima Protocol in lowering post-operative complications in primary cleft palate repair surgery in Cleft and Craniofacial Center, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.Case Presentation : This study is a case series featuring 6 patients with cleft palate treated with primary palatoplasty. Surgical techniques were selected based on the degree of severity measured by Palatal Index. The average age of performing primary palatoplasty was 14 months. 50% of the cases was classified as Veau 2 and the rest was Veau 3. Half of the patients fell into severe category based on Palatal Index and the other half was in moderate group. None of the patients developed fistula formation 3 months post-palatoplasty.Discussion & Conclusion: We confirmed that the 1-flap technique provided adequate closure comparable with the 2-flap technique without risking mucoperiosteal flap necrosis and fistula formation. Using the strengths of different surgical techniques individualized for each case based on the palatal index and grade of severity is indisputably a practical strategy. Trials with longer follow-ups are required to widely implement The Lima Protocol.
背景:腭裂修复技术面临着重大的发展。更重要的是，没有一种手术方案能显著降低术后并发症的发生率，如瘘管形成、腭咽功能不全或言语性鼻音亢进。由于腭裂宽度是预后的重要预测因素，因此引入Lima方案，根据腭指数测量的严重程度选择合适的手术技术。本文旨在评价在印度尼西亚雅加达Cipto Mangunkusumo医院cleft and Craniofacial Center新建立的Lima方案在降低原发性腭裂修复手术术后并发症方面的效果。病例介绍:本研究是对6例腭裂患者进行一期腭裂成形术的病例分析。根据腭指数测量的严重程度选择手术技术。进行初级腭成形术的平均年龄为14个月。50%为Veau 2型，其余为Veau 3型。根据腭指数，半数患者为重度组，另一半为中度组。术后3个月无瘘形成。讨论与结论:我们证实，与2瓣技术相比，1瓣技术提供了足够的闭合性，而不会有粘骨膜瓣坏死和瘘形成的风险。根据腭指数和严重程度，为每个病例使用不同的手术技术优势无疑是一种实用的策略。为广泛实施《利马议定书》，需要进行后续时间较长的试验。
{"title":"Lima Protocol for Cleft Palate Repair in Cleft and Craniofacial Centre Cipto Mangunkusumo Hospital Indonesia: A Preliminary Study","authors":"K. Bangun, J. Halim, V. Tania","doi":"10.14228/jprjournal.v9i1.337","DOIUrl":"https://doi.org/10.14228/jprjournal.v9i1.337","url":null,"abstract":"Background : The techniques of cleft palate repair has faced significant evolutions. More importantly, no surgical protocol has been significantly associated with lower incidence of post-operative complications such as fistula formation, velopharyngeal insufficiency, or speech hypernasality. As cleft width is a strong predictor of outcomes, The Lima Protocol was introduced to select suitable surgical technique based on the degree of severity measured by palatal index. This article aimed to evaluate the efficacy of the newly established Lima Protocol in lowering post-operative complications in primary cleft palate repair surgery in Cleft and Craniofacial Center, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.Case Presentation : This study is a case series featuring 6 patients with cleft palate treated with primary palatoplasty. Surgical techniques were selected based on the degree of severity measured by Palatal Index. The average age of performing primary palatoplasty was 14 months. 50% of the cases was classified as Veau 2 and the rest was Veau 3. Half of the patients fell into severe category based on Palatal Index and the other half was in moderate group. None of the patients developed fistula formation 3 months post-palatoplasty.Discussion & Conclusion: We confirmed that the 1-flap technique provided adequate closure comparable with the 2-flap technique without risking mucoperiosteal flap necrosis and fistula formation. Using the strengths of different surgical techniques individualized for each case based on the palatal index and grade of severity is indisputably a practical strategy. Trials with longer follow-ups are required to widely implement The Lima Protocol.","PeriodicalId":364477,"journal":{"name":"Jurnal Plastik Rekonstruksi","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122463695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-07DOI: 10.14228/jprjournal.v9i1.332
K. Bangun, J. Halim, Siti Handayani
Introduction: Zygoma fractures with orbital involvement, are the most common midfacial traumas, which cause severe aesthetic and functional sequelae. Late reduction of orbital floor fracture may result in entrapment of orbital soft tissue, predisposing the occurrence of enophthalmos. This article aimed to report enopthalmus correction in neglected tetrapod zygoma fracture case with autologous diced cartilage graft and fascia lata graft.Case Presentation: A 42-year-old female was injured in a traffic accident 8 years ago. Facial fracture was not repaired surgically, resulting in facial asymmetry and diplopia. Physical examination revealed right-sided zygoma deformity, 5mm dystopia, depressed malar eminence, gaze restriction and enophthalmus on the right eye. 3D CT scan confirmed a malunited neglected tetrapod zygoma fracture.Result: Corrective osteotomy was performed to reconstruct the tetrapod zygoma fracture using combination of bicoronal, infracilliary, and maxillary vestibular approach. 4-point fixation and stepladder modification was used. 1.6 cc of cartilage-derived diced bone graft was inserted on the posterior orbital floor to repair enophthalmos. Six months follow-up revealed improved dystopia and malar prominence. Additional surgery was done to repair scleral show and smoothen and augment lower lid volume using 4.5x0.6 cm fascia lata graft hammocked from the medial canthus to lateral orbital bone.Discussion & Conclusion: Long neglected zygoma fracture possessed a difficulty in reconstructing malunited zygoma articulation. Good aesthetic and functional outcome are achievable following use of diced cartilage and fascia lata graft for enophthalmus correction in neglected zygoma-orbital fracture, suggesting the role of fascia lata sling graft for treatment of scleral show and lower lid volume replacement.
{"title":"Repair of Enophthalmus in Neglected Tetrapod Zygoma Fracture with Diced Cartilage Graft and Fascia Lata Sling Graft: A Case Report","authors":"K. Bangun, J. Halim, Siti Handayani","doi":"10.14228/jprjournal.v9i1.332","DOIUrl":"https://doi.org/10.14228/jprjournal.v9i1.332","url":null,"abstract":"Introduction: Zygoma fractures with orbital involvement, are the most common midfacial traumas, which cause severe aesthetic and functional sequelae. Late reduction of orbital floor fracture may result in entrapment of orbital soft tissue, predisposing the occurrence of enophthalmos. This article aimed to report enopthalmus correction in neglected tetrapod zygoma fracture case with autologous diced cartilage graft and fascia lata graft.Case Presentation: A 42-year-old female was injured in a traffic accident 8 years ago. Facial fracture was not repaired surgically, resulting in facial asymmetry and diplopia. Physical examination revealed right-sided zygoma deformity, 5mm dystopia, depressed malar eminence, gaze restriction and enophthalmus on the right eye. 3D CT scan confirmed a malunited neglected tetrapod zygoma fracture.Result: Corrective osteotomy was performed to reconstruct the tetrapod zygoma fracture using combination of bicoronal, infracilliary, and maxillary vestibular approach. 4-point fixation and stepladder modification was used. 1.6 cc of cartilage-derived diced bone graft was inserted on the posterior orbital floor to repair enophthalmos. Six months follow-up revealed improved dystopia and malar prominence. Additional surgery was done to repair scleral show and smoothen and augment lower lid volume using 4.5x0.6 cm fascia lata graft hammocked from the medial canthus to lateral orbital bone.Discussion & Conclusion: Long neglected zygoma fracture possessed a difficulty in reconstructing malunited zygoma articulation. Good aesthetic and functional outcome are achievable following use of diced cartilage and fascia lata graft for enophthalmus correction in neglected zygoma-orbital fracture, suggesting the role of fascia lata sling graft for treatment of scleral show and lower lid volume replacement.","PeriodicalId":364477,"journal":{"name":"Jurnal Plastik Rekonstruksi","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134589837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-07DOI: 10.14228/jprjournal.v9i1.334
Nandita Melati Putri, Ruth Fitri Margareta Lumbuun, P. Kreshanti, Y. Saharman, Narottama Tunjung
Background : Pressure injury is a localized soft tissue injury caused by prolonged pressure over bony prominence. Most published papers used Manuka honey as dressing, while this product is expensive. As this reason, this study will use local product honey called Nusantara honey, to prove the use of local honey has better healing process, bacterial profile, and cost effectiveness, compared to the standard dressing, hydrogel.Method : This is a one-month experimental study conducted in patients with pressure injury that referred to our division. Parameter of the bacterial profile was taken from deep-tissue specimen. The healing process was examined with Pressure Ulcer Scale for Healing (PUSH) Tool. Cost was accumulated after all the treatment. Data was analysed with t-Test or Mann Whitney (if the distribution is not normal), with statistical significance was define as p<0.05..Result : Of 26 wounds, 12 were randomized to hydrogel and 14 to honey dressing. Characteristics were determined by sex, age, body mass index, level of consciousness, mobilization status, immobilization etiology, comorbidities, grade and location of ulcer, hemoglobin, leukocytes, and albumin level. There was clinically significant wound size reduction in honey dressing according to PUSH Tool (p=0.118). The bacterial profile and reduction were similar. Honey dressing appeared to be more cost effective in terms of dressing cost (p<0.001) and lower total cost.Conclusion: The local honey dressing has better wound healing outcome, although it is not statistically significant. Its capability of decreasing pathogens is similar with hydrogel, with lower cost, particularly the dressing cost. This local honey dressing could be a good choice as wound dressing in areas where the modern dressings are not available.
{"title":"Comparison Study of Bacterial Profile, Wound Healing, and Cost Effectiveness in Pressure Injury Patients Using Treatment Honey Dressing and Hydrogel","authors":"Nandita Melati Putri, Ruth Fitri Margareta Lumbuun, P. Kreshanti, Y. Saharman, Narottama Tunjung","doi":"10.14228/jprjournal.v9i1.334","DOIUrl":"https://doi.org/10.14228/jprjournal.v9i1.334","url":null,"abstract":"Background : Pressure injury is a localized soft tissue injury caused by prolonged pressure over bony prominence. Most published papers used Manuka honey as dressing, while this product is expensive. As this reason, this study will use local product honey called Nusantara honey, to prove the use of local honey has better healing process, bacterial profile, and cost effectiveness, compared to the standard dressing, hydrogel.Method : This is a one-month experimental study conducted in patients with pressure injury that referred to our division. Parameter of the bacterial profile was taken from deep-tissue specimen. The healing process was examined with Pressure Ulcer Scale for Healing (PUSH) Tool. Cost was accumulated after all the treatment. Data was analysed with t-Test or Mann Whitney (if the distribution is not normal), with statistical significance was define as p<0.05..Result : Of 26 wounds, 12 were randomized to hydrogel and 14 to honey dressing. Characteristics were determined by sex, age, body mass index, level of consciousness, mobilization status, immobilization etiology, comorbidities, grade and location of ulcer, hemoglobin, leukocytes, and albumin level. There was clinically significant wound size reduction in honey dressing according to PUSH Tool (p=0.118). The bacterial profile and reduction were similar. Honey dressing appeared to be more cost effective in terms of dressing cost (p<0.001) and lower total cost.Conclusion: The local honey dressing has better wound healing outcome, although it is not statistically significant. Its capability of decreasing pathogens is similar with hydrogel, with lower cost, particularly the dressing cost. This local honey dressing could be a good choice as wound dressing in areas where the modern dressings are not available.","PeriodicalId":364477,"journal":{"name":"Jurnal Plastik Rekonstruksi","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127758603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-07DOI: 10.14228/jprjournal.v9i1.335
H. Y. Wihastyoko, Wicaksono Patria Wuryanjono
Introduction : Hypertrophic scarring is a complication that occurs in post-surgical wounds. There are many ways to prevent scarring, but there have been no satisfactory methods yet. Moreover, no studies investigated the effectiveness of intradermal sutures. Polypropylene thread can be used to repair a scar after surgery. This study aimed to prove the effectiveness of intradermal sutures using polypropylene thread on surgical scar quality.Method : The study was conducted using a randomized, controlled trial, and post-test only with 20 rats (Rattus norvegicus) as animal subjects. The wounds were made on the back, approximately 6 mm x 2 cm. Then, the rats were divided into two groups: a control group without intradermal sutures (K) and treatment group with intradermal sutures (I). Histopathological examination using Hematoxylin and Eosin (H&E) staining was used to identify the fibroblast number on the 21st day. The fibrocytes number were also observed on the 12th week and the Vancouver Scar Scale (VSS) was used to assess the scar quality.Result : The number of fibroblasts and fibrocytes in the control group (K) was significantly smaller (53.60 ± 14.571; 3.20 ± 0.447) than the treatment (I) (243.20 ± 75.334; 171.40 ± 13.221). The VSS value was significantly greater in the control than the treatment.Conclusion: The intradermal sutures using polypropylene thread produced a better-quality scar after surgery compared to wounds without intradermal sutures.
{"title":"The Effectiveness of Intradermal Suture Technique on Hypertrophic Scar Prevention in Rats","authors":"H. Y. Wihastyoko, Wicaksono Patria Wuryanjono","doi":"10.14228/jprjournal.v9i1.335","DOIUrl":"https://doi.org/10.14228/jprjournal.v9i1.335","url":null,"abstract":"Introduction : Hypertrophic scarring is a complication that occurs in post-surgical wounds. There are many ways to prevent scarring, but there have been no satisfactory methods yet. Moreover, no studies investigated the effectiveness of intradermal sutures. Polypropylene thread can be used to repair a scar after surgery. This study aimed to prove the effectiveness of intradermal sutures using polypropylene thread on surgical scar quality.Method : The study was conducted using a randomized, controlled trial, and post-test only with 20 rats (Rattus norvegicus) as animal subjects. The wounds were made on the back, approximately 6 mm x 2 cm. Then, the rats were divided into two groups: a control group without intradermal sutures (K) and treatment group with intradermal sutures (I). Histopathological examination using Hematoxylin and Eosin (H&E) staining was used to identify the fibroblast number on the 21st day. The fibrocytes number were also observed on the 12th week and the Vancouver Scar Scale (VSS) was used to assess the scar quality.Result : The number of fibroblasts and fibrocytes in the control group (K) was significantly smaller (53.60 ± 14.571; 3.20 ± 0.447) than the treatment (I) (243.20 ± 75.334; 171.40 ± 13.221). The VSS value was significantly greater in the control than the treatment.Conclusion: The intradermal sutures using polypropylene thread produced a better-quality scar after surgery compared to wounds without intradermal sutures.","PeriodicalId":364477,"journal":{"name":"Jurnal Plastik Rekonstruksi","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121803566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-07DOI: 10.14228/jprjournal.v9i1.336
YunitaDwi Ariani, Bambang Wicaksono
Introduction : The nasal tip abscess is a rare pathology that affects the soft tissue of the nasal tip, with risk of damaging the cartilaginous framework with the resulting alteration of the anatomy and function of the nose, if not treated properly.Case Presentation : A 22-year old female patient developed progressive defect with pain sensation at her nasal tip after bumping her nose 2 months ago and she admitted that she underwent a thread rhinoplasty 1 year ago. The reconstructive surgery was performed by excision of the ulcer, threads evacuation, and closing the defect with paramedian forehead flap procedure.Summary: In this case, the problem can be treated very well with the paramedian forehead flap procedure which is an excellent option for nose reconstruction.
{"title":"Paramedian Forehead Flap for Nasal Tip Reconstruction Related to Barbed Suture Infection","authors":"YunitaDwi Ariani, Bambang Wicaksono","doi":"10.14228/jprjournal.v9i1.336","DOIUrl":"https://doi.org/10.14228/jprjournal.v9i1.336","url":null,"abstract":"Introduction : The nasal tip abscess is a rare pathology that affects the soft tissue of the nasal tip, with risk of damaging the cartilaginous framework with the resulting alteration of the anatomy and function of the nose, if not treated properly.Case Presentation : A 22-year old female patient developed progressive defect with pain sensation at her nasal tip after bumping her nose 2 months ago and she admitted that she underwent a thread rhinoplasty 1 year ago. The reconstructive surgery was performed by excision of the ulcer, threads evacuation, and closing the defect with paramedian forehead flap procedure.Summary: In this case, the problem can be treated very well with the paramedian forehead flap procedure which is an excellent option for nose reconstruction.","PeriodicalId":364477,"journal":{"name":"Jurnal Plastik Rekonstruksi","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133949777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-07DOI: 10.14228/jprjournal.v9i1.326
Nungki Ratna Martina, Ester P Andyni Manalu, Adilla Ramadhania, Bony P Simbolon
Introduction : Zygomaticomaxillary complex (ZMC) fractures are one of the most common fractures of the facial skeleton. Zygomatic fractures can cause ocular and mandibular functional impairment, along with cosmetic defects. The characteristic clinical signs of zygomatic bone fracture include diplopia, infraorbital nerve paraesthesia, flattening of the cheek, and trismus, whereas maxillary fracture may typically cause flattening of the midface and malocclusion. Therefore, surgical reconstruction is required to restore the function and appearance.Case Report : A 31-year-old man with ZMC fracture and globe rupture underwent open reduction and internal fixation using plate and orbital mesh. We collaborated with an ophthalmologist who performed enucleation and tarsorrhaphy.Discussion : The reconstruction improved functional and physical aspects and therefore psychological wellbeing. The main goal of the ZMC fracture treatment is to reconstruct the face in terms of functions and aesthetic. Furthermore, reconstruction of the left orbit (orbital rims and walls) as a secondary objective despite the blind eye, improved his appearance enabling formation of a pocket into which an eye implant was inserted. Satisfying functional and aesthetic outcome was achieved in this patient.Conclusion: A teamwork approach in surgical reconstruction for this case with ZMC fracture which always has an orbital component, was recommended to obtain an effective and optimal result. Both plastic surgeon and ophthalmologist can elaborate patient needs for facial reconstruction especially orbital region with good result.
{"title":"Teamwork Approach in Management of Zygomaticomaxillary Complex (ZMC) Fracture with Globe Rupture: A Case Report","authors":"Nungki Ratna Martina, Ester P Andyni Manalu, Adilla Ramadhania, Bony P Simbolon","doi":"10.14228/jprjournal.v9i1.326","DOIUrl":"https://doi.org/10.14228/jprjournal.v9i1.326","url":null,"abstract":"Introduction : Zygomaticomaxillary complex (ZMC) fractures are one of the most common fractures of the facial skeleton. Zygomatic fractures can cause ocular and mandibular functional impairment, along with cosmetic defects. The characteristic clinical signs of zygomatic bone fracture include diplopia, infraorbital nerve paraesthesia, flattening of the cheek, and trismus, whereas maxillary fracture may typically cause flattening of the midface and malocclusion. Therefore, surgical reconstruction is required to restore the function and appearance.Case Report : A 31-year-old man with ZMC fracture and globe rupture underwent open reduction and internal fixation using plate and orbital mesh. We collaborated with an ophthalmologist who performed enucleation and tarsorrhaphy.Discussion : The reconstruction improved functional and physical aspects and therefore psychological wellbeing. The main goal of the ZMC fracture treatment is to reconstruct the face in terms of functions and aesthetic. Furthermore, reconstruction of the left orbit (orbital rims and walls) as a secondary objective despite the blind eye, improved his appearance enabling formation of a pocket into which an eye implant was inserted. Satisfying functional and aesthetic outcome was achieved in this patient.Conclusion: A teamwork approach in surgical reconstruction for this case with ZMC fracture which always has an orbital component, was recommended to obtain an effective and optimal result. Both plastic surgeon and ophthalmologist can elaborate patient needs for facial reconstruction especially orbital region with good result.","PeriodicalId":364477,"journal":{"name":"Jurnal Plastik Rekonstruksi","volume":"647 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122696394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-06DOI: 10.14228/jprjournal.v8i2.325
Marcella Tirza Tulong, M. H. Oley, M. Oley, A. Sundoro, M. Faruk
Introduction: The unique anatomy of the ear makes the reconstruction more challenging. Microtia and auricula hematomas are deformities or defects that can occur in the ear. Treating traumatic injury and congenital malformations of the ears needs some technique and expertise. Hyperbaric Oxygen Therapy is an additional therapy that makes a significant contribution and is effective in wound healing. Case Series: In our first case, a 52-year-old man presented with a traumatic right cauliflower ear due to a traffic accident two weeks before hospital admission. The second case involves a boy 14-year-old who has a Microtia in the right ear with total ear construction performed using autologous costochondral cartilage techniques in a two-stage. Results: Both cases following hyperbaric oxygen therapy, yield good results with good scars, no sign of infection nor tissue necrosis Summary: The combination therapy of reconstructive surgery and administration of oxygen therapy gave satisfactory results in both cases. Five sessions of hyperbaric treatment showed promising results. There is no infection, rapid wound healing, and cessation of flap compromise.
{"title":"The Use of Hyperbaric Oxygen Therapy for Ear Reconstruction: A Case Series","authors":"Marcella Tirza Tulong, M. H. Oley, M. Oley, A. Sundoro, M. Faruk","doi":"10.14228/jprjournal.v8i2.325","DOIUrl":"https://doi.org/10.14228/jprjournal.v8i2.325","url":null,"abstract":"Introduction: The unique anatomy of the ear makes the reconstruction more challenging. Microtia and auricula hematomas are deformities or defects that can occur in the ear. Treating traumatic injury and congenital malformations of the ears needs some technique and expertise. Hyperbaric Oxygen Therapy is an additional therapy that makes a significant contribution and is effective in wound healing.\u0000Case Series: In our first case, a 52-year-old man presented with a traumatic right cauliflower ear due to a traffic accident two weeks before hospital admission. The second case involves a boy 14-year-old who has a Microtia in the right ear with total ear construction performed using autologous costochondral cartilage techniques in a two-stage.\u0000Results: Both cases following hyperbaric oxygen therapy, yield good results with good scars, no sign of infection nor tissue necrosis\u0000Summary: The combination therapy of reconstructive surgery and administration of oxygen therapy gave satisfactory results in both cases. Five sessions of hyperbaric treatment showed promising results. There is no infection, rapid wound healing, and cessation of flap compromise.","PeriodicalId":364477,"journal":{"name":"Jurnal Plastik Rekonstruksi","volume":"106 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133923966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-30DOI: 10.14228/jprjournal.v8i2.330
E. Setiawan, A. Wardhana, W. Sinaga, A. D. Sari, Metta Satyani, L. I. Octovia
Backgrounds: Diarrhea frequently occurs in severely burned patients attributable to impaired intestinal integrity and dysbiosis. Soluble fiber may improve intestinal barrier function, avoid bacterial translocation, then subsequently prevent and treat diarrhea. Soluble fiber is rapidly fermented by commensal bacteria and produces short-chain fatty acids (SCFA). Case Reports: A 51-year-old male with severe burn injury involving 53,5% total body surface area (TBSA) and diarrhea were given soluble fiber as part of his diet. Results: Administration of 6–10 g/d soluble fiber clinically improves stool consistency, assessed by Bristol Stool Scale, in the severely burned patient. The patient was discharged after 19 days of hospitalization with improvement in clinical condition. Summary: SCFA maintains intestinal integrity, supports the growth of commensal bacteria, and inhibits pathogens. There is no specific recommendation regarding fiber intake in burned patients
{"title":"Dietary Soluble Fiber Improved Fecal Consistency in Burned Patients with Diarrhea","authors":"E. Setiawan, A. Wardhana, W. Sinaga, A. D. Sari, Metta Satyani, L. I. Octovia","doi":"10.14228/jprjournal.v8i2.330","DOIUrl":"https://doi.org/10.14228/jprjournal.v8i2.330","url":null,"abstract":"Backgrounds: Diarrhea frequently occurs in severely burned patients attributable to impaired intestinal integrity and dysbiosis. Soluble fiber may improve intestinal barrier function, avoid bacterial translocation, then subsequently prevent and treat diarrhea. Soluble fiber is rapidly fermented by commensal bacteria and produces short-chain fatty acids (SCFA).\u0000Case Reports: A 51-year-old male with severe burn injury involving 53,5% total body surface area (TBSA) and diarrhea were given soluble fiber as part of his diet.\u0000Results: Administration of 6–10 g/d soluble fiber clinically improves stool consistency, assessed by Bristol Stool Scale, in the severely burned patient. The patient was discharged after 19 days of hospitalization with improvement in clinical condition.\u0000Summary: SCFA maintains intestinal integrity, supports the growth of commensal bacteria, and inhibits pathogens. There is no specific recommendation regarding fiber intake in burned patients","PeriodicalId":364477,"journal":{"name":"Jurnal Plastik Rekonstruksi","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134511951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-30DOI: 10.14228/jprjournal.v8i2.331
I. G. A. Purwanthi, Agus Roy Rusly Hariantana Hamid, I Gusti Putu Hendra Sanjaya, I Made Suka Adnyana, Gede Wara Samsarga, Nyoman Siska Ananda
Background: Congenital bifid tongue without other craniofacial abnormalities is a very rare malformation. Here, we discuss a case of the bifid tongue with cleft palate, reported in a 7-month-old girl with no other syndromes or craniofacial abnormalities. Case Reports: This case report described a 7-month-old girl with an anterior bifid tongue, separated medially by a soft, solitary sublingual mass measuring 3 cm x 2 cm in size. There was also an associated incomplete cleft palate. A soft solitary mass measuring 2 cm x 2 cm in size was also seen within the cleft palate. Results: Computed facial tomography (CT) revealed a midline hard palate defect with an intact alveolar process of the maxilla. Pedunculated cystic lesion suspected with epulis was noted to arise on premaxillary alveolar mucosa. Excision of the tongue and hard palate mass and repair of the bifid tongue were done. Summary: Congenital bifid tongue with a cleft is a very rare malformation with different variations. Early surgical intervention is critical to prevent speech impairment and swallowing disorders. A multidisciplinary approach, including well-planned staged operations and rehabilitation, is important to achieve favorable outcomes.
背景:无其他颅面畸形的先天性舌裂是一种非常罕见的畸形。在这里，我们讨论的情况下，舌裂腭裂，报告在一个7个月大的女孩没有其他综合征或颅面异常。病例报告:本病例报告描述了一个7个月大的女孩，舌前裂，中间有一个软的、孤立的舌下肿块，大小为3厘米× 2厘米。还伴有不完全性腭裂。腭裂内可见2 cm × 2 cm大小的软孤立肿块。结果:计算机面部断层扫描(CT)显示上颌中线硬腭缺损伴完整的牙槽突。在上颌前牙槽黏膜上可见疑似脓包的带蒂囊性病变。切除舌及硬腭肿块，修复舌裂。摘要:先天性舌裂伴唇裂是一种非常罕见的畸形。早期手术干预是预防语言障碍和吞咽障碍的关键。多学科的方法，包括精心规划的分期手术和康复，对取得良好的效果至关重要。
{"title":"Bifid Tongue and Cleft Palate: A Rare Congenital Malformation","authors":"I. G. A. Purwanthi, Agus Roy Rusly Hariantana Hamid, I Gusti Putu Hendra Sanjaya, I Made Suka Adnyana, Gede Wara Samsarga, Nyoman Siska Ananda","doi":"10.14228/jprjournal.v8i2.331","DOIUrl":"https://doi.org/10.14228/jprjournal.v8i2.331","url":null,"abstract":"Background: Congenital bifid tongue without other craniofacial abnormalities is a very rare malformation. Here, we discuss a case of the bifid tongue with cleft palate, reported in a 7-month-old girl with no other syndromes or craniofacial abnormalities.\u0000Case Reports: This case report described a 7-month-old girl with an anterior bifid tongue, separated medially by a soft, solitary sublingual mass measuring 3 cm x 2 cm in size. There was also an associated incomplete cleft palate. A soft solitary mass measuring 2 cm x 2 cm in size was also seen within the cleft palate.\u0000Results: Computed facial tomography (CT) revealed a midline hard palate defect with an intact alveolar process of the maxilla. Pedunculated cystic lesion suspected with epulis was noted to arise on premaxillary alveolar mucosa. Excision of the tongue and hard palate mass and repair of the bifid tongue were done.\u0000Summary: Congenital bifid tongue with a cleft is a very rare malformation with different variations. Early surgical intervention is critical to prevent speech impairment and swallowing disorders. A multidisciplinary approach, including well-planned staged operations and rehabilitation, is important to achieve favorable outcomes.","PeriodicalId":364477,"journal":{"name":"Jurnal Plastik Rekonstruksi","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130218378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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