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"[ABSTRAKPendahuluan :Fraktur Midface merupakan fraktur yang sering terjadi dapat dapat memberikan efek baik dari segi estetik dan fungsi. Fraktur Midface yang tidak ditangani dengan baik akan merubah bentuk wajah menjadi tidak proporsional, salah satunya wajah yang menjadi lebih lebar dan panjang, terdapat depresi malar. Tata laksana dengan reposisi segmen fraktur dan fiksasi interna merupakan pilihan utama.Metode :Data yang diambil dari status estetik dengan menggunakan studi cross sectional pada pasien dengan fraktur midface sebelum operasi ORIF didapatkan di rekam medis, dan data setelah opeasi ORIF didapatkan dari follow up (4 years), kemudian dilakukan pengukuran dari proyeksi vertical, horizontal dan warm?s view .Hasil :Berdasarkan analisis fotografi dari proyeksi vertikal didapatkan 3 pasien memiliki proporsi muka yang baik, 3 pasien memiliki proporsi wajah yang baik dikarenakan perbedaan rata-rata. Berdasarkan analisis fotografi dari proyeksi horizontal didapatkan 3 pasien memiliki panjang muka yang berbeda, 2 pasien memiliki dystopia, 1 pasien memiliki enophtalmus. Berdasarkan analisi fotografi dari proyeksi worm?s eye didapatkan 4 pasien memiliki depresi malar eminensMengenai hasil estetika, didapatkan 4 pasien (66,6 %) puas dengan simetrisitas wajah setelah operasi. 2 pasien (33,3 %) mengeluhkan tidak puas dengan penampilan akhir setelah operasiKesimpulan :Untuk dapat mengevaluasi hasil operasi ORIF di Divisi Bedah Plastik Rumah Sakit Ciptomangunkusumo. Tidak hanya dibutuhkan registrasi data awal yang baik, tetapi juga dibutuhkan sarana dan fasilitas untuk mendapatkan evaluasi jangka panjang pada pasien terutama lokasi pasien yang jaraknya jauh dari lokasi rumah sakit.

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ABSTRACTBackground :Midface fracture is a fracture that often occurs may be able to give a good effect in terms of aesthetics and functionality. Midface fracture that is not handled properly will change the shape of the face become disproportionate, one of which face becomes wider and longer, there is a malar depression. The management of the segment repositioning fracture and internal fixation is the main option.Methods:Data taken from the status aesthetic using cross sectional study in patients with fractures midface before surgery ORIF obtained in medical records, and the data after opeasi ORIF obtained from follow-up (4 years), then the measurement of the projected vertical, horizontal and warm's view.Result:Based on the photographic analysis of the vertical projection obtained 3 patients have a good proportion of the face, 3 patients had good facial proportions due to differences in average. Based on the photographic analysis of horizontal projection obtained 3 patients had a different face long, 2 patients had a dystopia, 1 patient had enophtalmus. Based on the photographic analysis of the worm's eye projection obtained 4 patients had a malar depression eminens.Regarding the aesthetic results, obtained four patients (66.6%) are satisfied with simetrisitas face after surgery. 2 patients (33.3%) complained of is not satisfied with the final appearance after surgeryConclusions:To be able to evaluate the results of ORIF surgery in the Division of Plastic Surgery Hospital Ciptomangunkusumo. Not only the data registration needed a good start, but also the infrastructure and facilities needed to obtain a long-term evaluation of the patients, especially the location of patients that were located far from the location of the hospital, Background :Midface fracture is a fracture that often occurs may be able to give a good effect in terms of aesthetics and functionality. Midface fracture that is not handled properly will change the shape of the face become disproportionate, one of which face becomes wider and longer, there is a malar depression. The management of the segment repositioning fracture and internal fixation is the main option.Methods:Data taken from the status aesthetic using cross sectional study in patients with fractures midface before surgery ORIF obtained in medical records, and the data after opeasi ORIF obtained from follow-up (4 years), then the measurement of the projected vertical, horizontal and warm's view.Result:Based on the photographic analysis of the vertical projection obtained 3 patients have a good proportion of the face, 3 patients had good facial proportions due to differences in average. Based on the photographic analysis of horizontal projection obtained 3 patients had a different face long, 2 patients had a dystopia, 1 patient had enophtalmus. Based on the photographic analysis of the worm's eye projection obtained 4 patients had a malar depression eminens.Regarding the aesthetic results, obtained four patients (66.6%) are satisfied with simetrisitas face after surgery. 2 patients (33.3%) complained of is not satisfied with the final appearance after surgeryConclusions:To be able to evaluate the results of ORIF surgery in the Division of Plastic Surgery Hospital Ciptomangunkusumo. Not only the data registration needed a good start, but also the infrastructure and facilities needed to obtain a long-term evaluation of the patients, especially the location of patients that were located far from the location of the hospital]"

"Latar Belakang: Tujuan dari manajemen luka bakar adalah untuk menginiasi penutupan luka dini atau epitelisasi, dan untuk mencegah komplikasi akibat sepsis. Namun, dari praktik harian kami, diagnosis dini, terutama dalam menentukan kedalaman luka bakar pada fase akut, cukup sulit karena proses luka bakar terus berlangsung. Pengukuran objektif merupakan metode tambahan yang baik untuk membantu dokter mengevaluasi kedalaman luka bakar, misalnya pencitraan termal FLIR ONE. Tujuan penelitian ini adalah untuk mengevaluasi validitas FLIR ONE termografi sebagai alat untuk menilai kedalaman luka bakar, dan keandalan evaluasi klinis dan FLIR ONE yang dilakukan oleh ahli konsultan ahli luka bakar bedah plastik dan senior residen bedah plastik. Metode: Studi diagnostik yang dilakukan dari November 2019 - April 2020 di pusat kami. Dengan kriteria inklusi disebutkan kami melakukan pengamatan dua kali berdasarkan evaluasi klinis dan juga alat bantu FLIR ONE termografi pada luka bakar superfisial dan mid-dermal dalam waktu 48 jam pascalukabakar, dan hari 3-5 pascalukabakar, dengan outcome yaitu evaluasi klinis yang dilakukan oleh ahli bedah plastik konsultan luka bakar berpengalaman di hari ke 7. Data dikumpulkan dan menganalisis validitas dan realibilitas. Hasil: 43 sampel yang diambil dari laki-laki 15 (53,6%) dan perempuan 13 (46,4%), usia rata-rata 41,82 ± 13,52 tahun. Sebagian besar sampel adalah dari wajah 14 (32,6%), dan ekstremitas atas 11 (25,6%). Realibitas: ICC adalah T1 0,95 dan T3 0,98, menunjukkan angka baik hingga hari ke 7 hari pascalukabar. Kesenjangan evaluasi klinis antara kedua pengamat (konsultan luka bakar bedah plastic berpengalaman dan residen bedah plastik senior) di T1 adalah 6,9% dan di T3 adalah 9,3%. Tidak ada perbedaan yang signifikan dalam penilaian klinis baik di T1 (p = 0,82) dan T3 (p = 0,51) dan tidak ada perbedaan yang signifikan dalam pengukuran menggunakan alat FLIR ONE antara dua pengamat baik di T1 (p = 0,25) dan T3 (p = 0,91 ). Validitas: AUC dihitung pada T1 adalah 0,72 (95% CI: 0,563 - 0,880) p = 0,014 dengan titik batas T1 pada -0,8 ° C, menunjukkan diskriminasi moderat antara kategori penyembuhan yang re-epitelisasi <= 7 hari dan > 7 hari (sensitivitas 62,5%; spesifisitas 78,9%). Kami menggabungkan evaluasi klinis dan T1 dalam waktu 48 jam setelah luka bakar, penggunaan Flir ONE sebagai alat tambahan meningkatkan sensitivitas menjadi 58,33%, spesifisitas 98% dari evaluasi klinis saja. Probabilitas re-epitelisasi temuan klinis kedalaman luka superfisial dengan nilai T1 > -0,8 C memiliki probabilitas tertinggi (90,94%) untuk re-epitelisasi dalam waktu kurang dari sama dengan 7 hari. Kesimpulan: Penelitian ini menunjukkan validitas dan reliabilitas yang baik dari evaluasi klinis saja dan evaluasi klinis dengan FLIR ONE termografi dalam menilai kedalaman luka bakar. Titik potong kami dalam menentukan kedalaman luka bakar adalah -0,8 ° C, dengan hasil probabilitas yang baik untuk membedakan hasil epitelisasi berulang. Penelitian ini juga memberi tahu kami bahwa program residensi bedah plastik di rumah sakit pendidikan kami telah berhasil membangun kompetensi modul yang baik, dan reisden memiliki paparan yang cukup terhadap kasus luka bakar.

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Background: The aim of the management of burn wound is to initiate early wound closure or epithelization, and to prevent sepsis complication. However, from our daily practice, early diagnosis especially in determining the depth of burn wound in acute phase, is quiet difficult as burn wound process is running. Objective measurement may be great adjunct methods to to help clinician evaluating burn wound depth, as an example of FLIR ONE thermal imaging. The objective was to evaluate the validity of FLIR ONE thermal imager as an adjunct tool to assess burn wound depth, and reliability of clinical evaluation and FLIR ONE performed by senior resident of plastic surgery and experienced burn consultant plastic surgeon. Methods: This is a diagnostic study conducted from November 2019 – April 2020 in our center. With inclusion criteria mentioned we did observation twice based on clinical visual and also FLIR ONE thermal imaging on superficial and mid dermal burn within 48 hours post burn, and post burn day 3-5, outcome by clinical evalution done by experienced burn consultant plastic surgeon on day 7. Data were collected and analyze validity and realibility. Result: We had 43 samples taken from male 15 (53,6%) and female 13 (46.4%), average age 41.82 ± 13.52 years. As facial 14(32.6%), and upper extremities 11 (25.6%) as most samples use. Reliability: ICCs were T1 0.95 and T3 0.98, indicating excellent reliability up to 7 days after burn. The gap of clinical evaluation between both observers (experienced burn consultant and senior plastic surgery resident) at T1 is 6.9 percent and at T3 is 9.3 percent. There were no significant difference in clinical assessment both in T1 (p=0.82) and T3 (p=0.51) and no significant difference in measurements using FLIR ONE between two observers both in T1 (p=0.25) and T3 (p=0.91). Validity: the area under the curve was calculated at T1 was 0.72 (95% CI: 0.563 – 0.880) p = 0.014 with a cut-off point of T1 at -0.8°C, shows a moderate discrimination between healing categories re-epithelialization <= 7 days and > 7 days (62.5% sensitivity; 78.9% specificity). We combined clinical evaluation and T1 within 48 hours post burn, the use of Flir One as an adjunct tool increased the sensitivity to 58.33%, specificity 98% of clinical evaluation solely. the probability of re-epithelialization of clinical finding of superficial wound depth with T1 value of >-0.8oC had the highest probability (90.94%) to re-epithelialized in less equal to 7 days. Conclusion: This research showed good validity and reliability of clinical evaluation alone and clinical evaluation adjunct with FLIR ONE thermal imaging in assessment of burn wound depth. Our cut off point in determining the burn wound depth was -0.8° C, with good probability result to differentiate re-epithelialization outcome. This research told us that plastic surgery residency program of our teaching hospital had successfully established a good module competency, and resident had enough exposure to the burn cases."

"Smith and Nesi’s ophthalmic plastic and reconstructive surgery, third edition has taken the best of the field’s classic reference text and expanded upon it, continuing its reputation as the foremost guide to the subspecialty. Every practitioner of plastic and reconstructive surgery will find useful information in this comprehensive, in-depth text, including an update on the changes and advances of the last several years and a new section on pediatric consideration. Detailed chapters on ophthalmic anatomy are also included, as well as sections on eyelid dermatology, socket surgery, and cosmetic surgery. Every consideration has been made by Dr. Nesi and his co-editors to cover every aspect important to the ophthalmic plastic surgeon.Features, fully updated and revised edition of Smith’s ophthalmic plastic and reconstructive surgery, comprehensive text with detailed chapters that cover all aspects of the subject matter, and more than 1700 figures and 77 chapters."

"Plastic surgery : a problem based approach provides a problem-based approach to solutions for common scenarios in plastic, reconstructive and aesthetic surgery and serves as a practical guide to managing a plastic surgical case.This book outlines a pathway through management for the clinician, consisting of six phases :1) Recognition of the condition: facilitated by high quality images.2) General approach: provided by an opening “mindset” statement for the particular case. 3) Assessment: the critical aspects of the history and examination.4) Treatment: key decisions and key interventions.5) Management: post-intervention expectations.6) Evidence : the rationale behind the preceding treatment and an overview of any controversies."

"Background: Pada program pelatihan residensi bedah Plastik, pengukiran framework untuk telinga luar pada prosedur mikrotia masih terbatas pada sistem magang. Menurut model berbasis simulasi, residen dapat dilatih sebelum menghadapi pasien sebenarnya. Penelitian ini akan menilai efisiensi dari program pelatihan pengukiran framework telinga luar untuk residen Bedah Plastik Rekonstruksi dan Estetik.Materials and Methods: 14 residen bedah plastik masuk dalam penelitian ini, terbagi menjadi dua grup. Grup I, terdiri dari residen yang pernah mengikuti prosedur mikrotia lebih dari 1 kali sebagai asisten atau pengukir sementara grup II beum pernah. Grup II akan mendapat program pelatihan yang terdiri dari kuliah dan video, dilanjutkan dengan pengukiran dengan subtitusi kartilago dalam bimbingan. Hasil akhir akan dinilai oleh 2 orang konsultan ahli bedah Mikrotia dalam hal presisi anatomi dan ukuran serta kecepatan pengukiran.Result: Penelitian menunjukkan terdapat peningkatan bermakna dalam hal kecepatan pengukiran dengan p=0.003 (p<0.005) antara 2 grup. Sementara dalam presisi anatomi, terdapat peningkatan bermakna pada tinggi tragus dengan p=0.003 (p<0.005) serta penurunann tinggi antitragus dengan p=0.000 (p<0.0005), dan pada nilai lain tidak terdapat perbedaaan yang signifikan diantara 2 grup. Conclusion: Dari penelitian ini, dapat disimpulkan bahwa kecuali tinggi anti tragus, hasil ini menunjukkan efektivitas program pelatihan antara mereka yang belum pernah mengikuti operasi mikrotia dengan mereka yang sudah berpengalaman.

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Background: In Plastic Surgery residency training program, cartilage carving of external ear reconstruction for Microtia's procedure was limited to traditional apprenticeship model. Under simulation based training, resident could be groomed before facing the real patient. This study will be evaluate the efficacy training program for cartilage carving of external ear framework for resident of Aesthetic Reconstructive Plastic Surgery.Materials and Methods: 14 plastic surgery resident will be enrolled in this study, separated into two group. Group I, consisted of resident had experience in Microtia's procedure more than once asisstant or carver meanwhile group II hadn't. Group II will had training program comprised of lecture and video then carving of cartilage substitute under guidance. A week later, both group would carve external ear cartilage framework without guidance. The final result will be assesed by two consultant of Microtia's surgeon in term of anatomical, size appearance of external ear and speed of carving.Result: Study showed that there was improvement in term of speed of carving with p = 0.003 (p<0.005) between both group. Meanwhile, in term of anatomical precision, there was improvement in tragal height with p=0.003 (p<0.005) and decline antitragal height with p=0.000 (p<0.0005), though in other points there was no significant differences between both team. Conclusion: From study, we concluded that except for antitragal height point, this result successfully demonstrated the effectiveness of the training program between those who had never experienced microtia's procedure before than those who had."