Jurnal Rekonstruksi dan Estetik

Jurnal Rekonstruksi dan Estetik, June 2024

2024-05-15T16:17:10+07:00

BACK MATTER

PROGNOSIS OF INHALATION INJURY MORTALITY RATE WITH REVISED BAUX SCORE AT DR. SOETOMO GENERAL ACADEMIC HOSPITAL, SURABAYA, INDONESIA (2019-2021)

2023-12-27T10:49:02+07:00

Highlights:

Fire is the most frequent cause of burns, while thermal contact is the least common.
Mortality rate with revised Baux score in burn patients with inhalation injury showed a significant relationship.

Abstract:

Introduction: Burn trauma has quite a high mortality rate in Indonesia. One of the scoring systems that is straightforward to apply is the revised Baux score. However, there is no standardised scoring system that is currently in use in our institution. Therefore, the purpose is to determine the feasibility of using this scoring system in our population's features.

Methods: This research is a retrospective study with research design case control design using secondary data in the form of medical record data from patients with acute burn trauma that were admitted to Burn Unit of Dr. Soetomo General Academic Hospital in Surabaya between January 2019 and December 2021. All the data will be divided by their group and analysed with SPSS software.

Results: The study found significant relationships between several factors and mortality rates among burn patients. Age, total burn surface area percentage, presence of inhalation injury, and the revised Baux Score all showed significant correlations with mortality rate (p < 0.005). Specifically, among burn patients with inhalation injury, the correlation between mortality rate and revised Baux score remained significant (p=0.002).

Conclusions:The study revealed that age, the percentage of total burn surface area, and the presence of inhalation injury are significantly associated with mortality rate among burn patients. Additionally, the revised Baux Score was identified as a useful tool for predicting the prognosis of burn patients with inhalation injury. These findings emphasize the importance of these factors in assessing and managing outcomes for burn patients, particularly those with inhalation injury.

THE OCCURRENCE OF CONTRACTURE AND THE SEVERITY OF BURN INJURIES AMONG BURN PATIENTS TREATED AT DR. SOETOMO GENERAL ACADEMIC HOSPITAL, SURABAYA, INDONESIA (2020-2022)

2024-01-02T08:59:57+07:00

Highlights:

A robust association was observed between total body surface area (TBSA) and burn injuries, except in the case of elderly individuals.
The duration of hospitalization is significantly associated with the occurrence of contracture.

Abstract:

Introduction: Burn injuries are a worldwide issue and can happen for many reasons, often causing skin damage that leads to deformities and movement difficulties. Many burn patients, up to 50%, experience contractures, which limit movement in areas such as the shoulders, wrists, and torso. Proper management through medicine, surgery, and therapy is crucial for helping these patients. Research at Dr. Soetomo General Academic Hospital is focused on studying the frequency of contractures after burn injuries to improve treatment and prevention methods.

Methods: The research used descriptive analytics and gathered data from the Burn Unit at Gedung Bedah Pusat Terpadu (GBPT) and the Plastic Surgery Polyclinic at Dr. Soetomo General Academic Hospital in Surabaya. The study examined 40 eligible patients and assessed variables including burn severity, affected body area, and hospitalization duration.

Results: The results showed that the average age of patients was 26.30 years, with 70% of them being male. Only 5% of patients had other health problems, mainly related to hormones. Most burns were caused by fire (37.5%), and many were second-degree burns (42.5%). The percentage of the body affected by burns varied by age: children had around 9.86%, adolescents had around 15.96%, and adults had around 5.25%. Most injuries were on the left arm (67.5%), and many patients stayed in the hospital for a long time (67.5%).

Conclusion: All patients developed contractures following burns, irrespective of burn severity. There was a correlation between burn size and severity, except among older patients. Additionally, a notable association was observed between contracture occurrence and prolonged hospitalization.

Front Matter Vol.9 No.1, 2024

2024-06-01T05:09:33+07:00

Front Matter Vol.9 No.1, 2024

REGENERATIVE MEDICINE IN BURN INJURY: A BIBLIOMETRIC ANALYSIS AND LITERATURE REVIEW

2024-04-24T08:53:10+07:00

Highlights:

This research analyzes regenerative medicine trends for burn injuries, providing valuable insights into focal points and article characteristics, enhancing understanding of this critical healthcare issue.
This research analyzes trends in regenerative medicine for burn injuries, highlighting emerging areas like 3D printing, nanotechnology, and photothermal therapy as promising future research directions.

Abstract:

Introduction: Burn injuries represent a significant global health concern, demanding effective management strategies to mitigate their impact. Regenerative medicine offers promising approaches to address burn injury management, utilizing innovative techniques to improve wound healing and tissue regeneration. This paper presents a comprehensive bibliometric analysis and literature review, highlighting trends, hotspots, and article profiles in the application of regenerative medicine for burn injury management, offering valuable insights for future research to enhance burn care.

Methods: A Scopus database search spanning from 2004 to 2024 was conducted using keywords related to regenerative medicine, burn injuries, and wound healing, yielding 602 relevant documents for analysis. Subsequent bibliometric analysis using VOSviewer and Biblioshiny identified key trends and contributors in the field.

Results: The results indicate an increase in research studies over the years, peaking in 2022, followed by a slight decline. Zhang Y emerged as the top researcher, with the United States leading in research output. Researchers primarily focused on four main areas: materials and techniques, injury management, cell-based therapies, and wound healing strategies. Emerging areas such as 3D printing, nanotechnology, and photothermal therapy are gaining interest for future research.

Conclusion: This study provides valuable insights into the evolving landscape of regenerative medicine for burn injury management. Zhang Y's significant contributions and the United States' leading role underscore the global effort in advancing research in this area. The exploration of new technologies like 3D printing and nanotechnology, alongside traditional approaches, signifies the dynamic nature of biomedical research in addressing burn injuries.

PEDIATRIC OCULAR TRAUMA MANAGEMENT: A CASE STUDY OF EFFECTIVE INTRA-ORBITAL FOREIGN BODY IOFB EXTRACTION

2023-10-12T15:43:39+07:00

Highlights:

The rare nature of Orbitocranial Injury with Intraorbital Foreign Body (IOFB).
Utilizing a 3D Head CT Scan to ascertain the precise location of the IOFB and its impact on anatomical structures is pivotal in shaping immediate treatment strategies, thereby reducing the potential for complications.

Abstract:

Introduction: Penetrating intraorbital foreign body (IOFB) injuries are a rare form of traumatic injury. Recognized as a surgical emergency, meticulous history-taking and a thorough examination are essential for determining the trauma's mechanism and cause, facilitating accurate diagnosis and effective disease management.

Case Illustration: In the emergency room, a 5-year-old female patient was presented with a craniofacial injury resulting from an IOFB. An evacuation procedure, conducted through a subsidiary incision, was performed to extract the foreign body. Interestingly, the object removed from the orbital cavity was a plastic foreign body, initially suspected to be a fractured orbital bone.

Discussion: The clinical presentation, management, and outcomes of orbital foreign body injuries can differ based on the material composition of the foreign body. In cases of intraorbital foreign body trauma, the primary treatment goal is foreign body removal.

Conclusion: Precise and accurate initial management in the emergency department is crucial. Early diagnosis, aided by a 3D head CT scan, is instrumental in locating the IOFB and identifying the involved anatomical structures. This, in turn, enables timely treatment decisions to minimize the risk of complications.

USING OF NEGATIVE WOUND PRESSURE THERAPY (NPWT): A CASE SERIES OF WOUND DISRUPTION AS A COMPLICATION OF A CAESAREAN SECTION

2024-01-22T08:24:28+07:00

Highlights:

Surgical site infection during caesarean section can cause complications, thereby increasing maternal mortality and morbidity, especially in groups at risk.
VAC therapy can stimulate granulation tissue formation so that primary wound junctions occur.
VAC shows its ability to close wounds entirely within 3-4 weeks.

Abstract:

Introduction: Wound disruption following caesarean sections is a common issue that can increase maternal mortality and morbidity. Several factors have been identified, including maternal, procedural, and antibiotic factors. The re-suturing method, primer, and secondary suture often fail, causing recurrent and delayed healing.

Case Illustration: CASE 1: A 26-year-old woman, 7 days post-caesarean section, presented with a wet wound and yellowish serous fluid. Three weeks later, wound dehiscence occurred despite re-debridement and re-suturing. Subsequent installation of VAC resulted in granulation tissue and re-epithelialization. CASE 2: A 32-year-old woman, 14 days post-caesarean section, complained of weakness and pus in the surgical wound. Upon examination, a red-yellowish fluid was found, indicating wound dehiscence. Re-debridement and VAC installation led to the formation of granulation tissue and re-epithelialization.

Discussion: VAC is the new wound care technique that suctions or collects excess exudate that absorbent gauze cannot accommodate. In comparison, absorbent gauze is limited in its capacity to absorb the fluid that produced in wounds. An innovation where the use of VAC, which has a negative pressure function, can stimulate granulation tissue to form and can bind the edges of the wound so that it can close naturally.

Conclusion: In instances of wound disruption following surgery, such as in the case of a caesarean section, it may be prudent to contemplate re-debridement followed by re-suturing. VAC presents itself as a viable alternative for managing wound dehiscence until the formation of granulation tissue.

A CASE SERIES AND LITERATURE REVIEW: MANAGEMENT STRATEGIES FOR RADIATION-INDUCED ULCERS OF THE CHEST

2024-01-30T16:13:41+07:00

Highlights:

Radiotherapy leads to a high occurrence of skin alterations and can advance to different levels of tissue damage, presenting challenges in treatment.
Management can be effective employing diverse wound treatment methods, although severe cases may necessitate surgical intervention.
Surgery takes into several key considerations to increase chances of success and tackle specific issues of chest wall instability and breast reconstruction.

Abstract:

Introduction: Radiotherapy as an adjunct to cancer treatment causes a high incidence of radiation-induced tissue injury, ranging from radiation dermatitis to severe osteoradionecrosis. Currently, no gold standard exists in the management of radiation injury. Various strategies ranging from modern wound treatment to surgical management have been studied.

Case Illustration: Three women presented with varying degrees of ulceration in the chest during or shortly following radiotherapy. Each case followed different approaches to management. One case solely received wound treatment, another received wound treatment and a sequestrectomy, and the third required surgical reconstruction of the chest wall and defect.

Discussion: Methods of wound treatment range from topical agents, barrier films and dressings, hydrogel and hydrocolloid dressings, miscellaneous treatments, and biodressings. Surgery is required in severe cases, particularly with osteoradionecrosis. This may include wound debridement, biopsy, chest wall stabilization, closure using various flaps, and potential breast reconstruction.

Conclusion: Radiation-induced ulcers of the chest pose a complex issue. Understanding effective treatment methods and key surgical principles is important for ensuring better outcomes. Further studies are needed to provide a complete guide to treatment.

A CASE REPORT: EARLOBE RECONSTRUCTION ON CONGENITAL AURICULAR LOBE DEFECT USING Z-PLASTY

2024-02-27T08:13:19+07:00

Highlights:

Congenital ear defects typically result from growth failures during the fifth to ninth weeks of gestation or from mechanical stress during this period.
Auricular lobuloplasty using the Z-plasty flap technique effectively addresses earlobe defects, resulting in optimal aesthetic outcomes with no keloid formation, minimal scarring, and no complications.

Abstract:

Introduction: Earlobe defects, often due to embryonal growth failure or injury, can affect aesthetics and social interactions despite not impacting hearing. Earlobe defect can be formed either from birth as congenital defect or secondary manifestation of other causes such as tumor and external factor such as earring usage or trauma. This study aimed to address these issues by performing auricular lobuloplasty using a Z-plasty flap technique. The procedure, crucial for protecting the auditory canal and facilitating eyeglass use, was successful in achieving the desired aesthetic outcome. Data on microtia prevalence, particularly in Indonesia, highlights the need for such reconstructive surgeries.

Case Illustration: A 9-year-old boy underwent auricular lobuloplasty to correct a cleft earlobe deformity, which caused social discomfort. The surgery, performed under general anesthesia, utilized a Z-plasty technique to lengthen and reorient the scar. Postoperative care included wound dressing changes and oral pain medication. After two weeks, satisfactory results were observed with no reported complications.

Discussion: The study on congenital ear deformities focuses on Z-plasty for earlobe reconstruction, detailing classifications, surgical techniques, and case results. The surgery was successful with minimal scarring and no keloid formation. Using Weerda's classification, the technique showed minimal scarring and no keloid formation. The approach, emphasizing proper skin envelope and alignment with Langer lines, offers effective aesthetic restoration, making it a valuable reference for future earlobe reconstruction cases.

Conclusion: Utilizing Z-plasty for earlobe defect reconstruction aids in improving the earlobe's appearance with minimal to no complications.