Jurnal Plastik Rekonstruksi

THE ACCEPTABILITY OF TELEMEDICINE IN POST-MASS CHARITY CIRCUMCISION IN INDONESIA: A PILOT STUDY

2022-12-30T01:28:59+00:00

Introduction: Charity circumcision is common in Indonesia. It is usually done by general practitioners or medical students under supervision. Procedures are often held on a mass scale and rarely followed with post-monitoring. We developed a telemedicine follow-up protocol to educate and address post-procedure complications. This pilot study evaluates the acceptability of telemedicine follow-up protocol for charity circumcision in Indonesia.

Method: Data were collected from operators and caregivers of children attending charity circumcision. The protocol consisted of text interviews (pain, urinary retention) and surgical sites' four-angle photographs (epithelialization, bleeding, infection, edema, and glans excoriation). The protocol was conducted two-way between caregivers and operators on days 1, 3, 7, and 30 after circumcision. The Ethics Committee of the Faculty of Medicine, Universitas Indonesia, has approved this study.

Result: Twenty-five boys with a mean age of 8.02±1.53 years old have similar pre-operative, operative, and postoperative protocols. Twenty-one caregivers completed four times follow-ups, one missed two times follow-ups, and three missed the last follow-up. Mild pain was the most reported complication, with 32% (8/25), 12% (3/25), 8% (2/24) incidence on days 1, 3, and 7, respectively. By the end of the follow-up, there were no persisting complications, and 80% (20/25) of boys showed complete epithelialization. All caregivers and most operators were satisfied with telemedicine for post-mass circumcision monitoring.

Conclusion: The telemedicine-based follow-up is acceptable and feasible to be applied in mass charity circumcision. This protocol is beneficial for monitoring the results and adverse events, therefore, should be routinely adopted in mass charity circumcision programs.

A FLAP MODALITY FOR RESURFACING FOLLOWING EXTERNAL GENITALIA TUMOR ABLATION: A CONSECUTIVE CASE SERIES

2023-05-30T03:22:08+00:00

Introduction : External genitalia defect may result from various cases such as vulvar cancer, cervical cancer, tumor metastases, etc. Female genitalia is challenging for reconstruction due to many complex anatomical structure like urethra, vagina, anus, and its a highly mobile region. It is need to reconstruct with high successful rate and low morbidity procedure. The aim of this paper is to report various flaps for resurfacing following external genitalia defect.

Method : From September 2017 - April 2022, 7 patients referred by Obstetric Gynecology Department to Plastic Surgery Division at Muhammad Hoesin Central General Hospital. The data was reviewed retrospectively to evaluate demographic, diagnosis, choice of flap reconstruction, functional and anatomical long term evaluation.

Result : The ages of the patients ranged from 29 - 67 year-old, diagnosed with cervical cancer with tumor metastases to vulva in 16% (n=1) and vulvar carcinoma 84% (n=5). Flaps performed: Antero-lateral Thigh (ALT) flap in 14,5% (n=1), gracilis flap in 28,5% (n= 2), rotation flap in 28,5% (n= 2), keystone flap in 28,5% (n=1). A major dehiscence and need required reoperation for abscess in 16% (n=1). Flap selection based on size, region, and anatomical structure defect. ALT was chosen for wide and bilateral vulvar and perineal defect, gracilis for unilateral vulvar and perineal defect, Keystone flap for half of vulvar and perineal defect, rotation flap for defect on mons region.

Conclusion: Flap selection in genitalia external reconstruction must be consider on the anatomical loss structure and defect size to achive durable tissue for acceptable functional and mobilisation. The algorithm may help to choose for flap based on loss area.

THE EFFECT OF ORALLY ADMINISTERED COENZYME Q10 ON THE VIABILITY OF RANDOM SKIN FLAP IN NICOTINE EXPOSED WISTAR RATS

2022-12-04T05:41:08+00:00

Introduction : Nicotine was assumed to be the cause of compromised flap. The administration of antioxidants can eliminate such effect, and one of the most promising antioxidants is Coenzyme Q10. The research aims to find the effect of orally administered Coenzyme Q10 on the viability of random skin flaps in nicotine-exposed wistar rats.

Method : Twenty-seven white rats (Rattus norvegicus) were assigned in three groups. The first group received no nicotine, while the other two groups were nebulized with nicotine for 4 consecutive weeks, and treated as random skin flaps. In third group, Coenzyme Q10 was administered for 7 days. Then, a standard histopathological staining and vascular endothelial growth factor (VEGF) measurement were performed on flap sample to examine the extent of neovascularization and VEGF cell expression.

Result : The average number of capillaries in group I was 5.33 ± 1.323, in group II was 5.89 ± 0.782, and in group III was 7.78 ± 2.587. There was no significant difference (p = 0.317, 95% CI) in groups I and II of VEGF expression. However, significant differences were found in the intensity of VEGF (p = 0.009, 95% CI) in groups I and group III, and in groups II and group III (p = 0.011, 95% CI). Thus, the intensity was stronger on the subject with coenzyme Q10 compared with the other two groups.

Conclusion: Coenzyme Q10 increases the viability of random flaps by increasing the number of capillaries and VEGF expression.

A POST OPERATIVE PALATOPLASTY FEEDING GUIDELINES: A LITERATURE REVIEW

2023-05-14T19:43:29+00:00

Introduction: Post operative palatoplasty is one of the important things, because many complications that may occur post operatively such as bleeding, dehiscence, to velopharyngeal insufficiency. One of the factors that determine postoperative palatoplasty wound healing is feeding problem which is still controversial, both in terms of the type of food and the time of feeding. There are no guidelines for handling postoperative palatoplasty in Indonesia. For this reason, the author tries to make a feeding guides post palatoplasty by compiling existing literature, to be used as a reference in making guidelines.

Method: Data collected from journal search engine with limited keyword. All article were analysed by authors to find focused data post palatoplasty feeding. All data is presented in a table, then compared and analysed.

Result: There are nine articles that met the inclusion and exclusion criteria were obtained which were presented in the table and compared.

Conclusion: Guidelines for post palatoplasty surgery must be made to provide the best results. Based on existing research and literature, the authors suggest including: a liquid diet after surgery, a soft diet as soon as possible, a solid diet after one month of surgery, and most importantly all diets must have good nutrition for Indonesia post palatoplasty feeding guidelines.

THE DOCUMENTATION OF CLEFT LIP AND PALATE PATIENTS AT THE DEWI SARTIKA HOSPITAL IN KENDARI

2023-05-14T19:36:15+00:00

Introduction : Cleft in the lips and palate is a congenital abnormality in the lip and palate. The incidence of oral cleft in the United States is estimated to be 1 in 700 births. Meanwhile, for Indonesia, especially the Southeast Sulawesi region, it has not been well documented.

Method : This is a retrospective study to determine the prevalence of cleft lip and cleft palate or labiopalatosc at Dewi Sartika Hospital in Kendari, Southeast Sulawesi between January and December 2018.

Result : Prevalence of Labioschisis, Palatoschisis and Labiopalatochisis on January-December 2018 is 23 patients (33%), 13 patients (19%) and 34 patients (49%). Presentation for each of kind unilateral are : unilateral labioschisis is 38 patients (66,7%) and bilateral labioschisis is 19 patients (33,3%). Presentation according to the place of defect labioschisis : right is 10 patients (17,6%), left 28 patients (49,1%), bilateral 19 patients (33,3%). Distribution kind of palatoschizis : complete palatoschizis is 49 patients (89%) and Incomplete palatoschizis is 6 patients (11%). Presentation labioschizis according to sex : Male 40 patients (57%), and female is 30 patients (43%).

Conclusion: The prevalence of cleft lip and palate has many forms, kind of labioschisis that large is unilateral labioschisis and localization defect is often on left edge. Complete labioschizis is large than incomplete palatoschizis. Labioschisis is happen more to male.