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"Praktik salah penyuntikan cairan silikon, parafin, atau beragam minyak lain ke berbagai bagian tubuh, diduga masih terus berlangsung dengan hadirnya pasien-pasien yang meminta pertolongan akibat menjadi korban praktik tersebut. Laporan ini menampilkan 3 kasus kerusakan kulit penis akibat silikonoma yang diterapi dengan eksisi kulit dan rekonstruksi dengan full thickness skin graft (FTSG). Eksisi kulit dilakukan dengan prosedur degloving dan defek yang dihasilkan ditutup dengan selembar FTSG yang diaplikasikan menutupi batang penis secara spiral. FTSG dipilih karena lebih tipis daripada flap dan lebih baik daripada split skin graft dalam hal kontraksi sekunder yang dihasilkan. Teknik apliksi FTSG secara spiral mudah dikerjakan dan menghasilkan luaran estetik dan fungsi yang baik. Ketiga kasus yang dilaporkan tidak disertai dengan problem parut dan tampak relatif normal. Ketiga pasien menyatakan puas dengan kembalinya fungsi seksual mereka.

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AbstractIn the midst of on-going non-illicit practice of silicone or paraffi n injection to enlarge penis, the author reported 3 cases of surgical treatment to resurface the body of the penis after excision of the destructed penile skin using full thickness skin graft. The skin excision was performed technically through penile body degloving procedure. Full thickness skin graft was then applied as a single sheet donor tissue to cover the denuded penile body spirally. The full thickness graft, which is relatively easy to be performed, is no doubt much thinner than a skin fl ap, while it also bears a smaller degree of secondary contraction than split skin graft. The color of the skin is considerably matched as it comes from the groin, which is a nearby area of penis. The size and skin sensitization of the penis looks to be natural. The only disadvantage is the common possibility of either spiral or circular junctional scar in between graft edges and between the graft and the penile mucosa and skin to develop hypertrophic scar. However, this possible scar problem applies also to any other surgical scar with any donor tissue. Fortunately, the 3 cases posed no scar problem and normal appearance. All the patients have also regained their normal sexual function. "

"ABSTRAKLatar Belakang: Rekonstruksi pada pasien Fournier Gangrene membutuhkan hasil yang baik secara fungsi dan estetik karena dapat mempengaruhi kondisi psikosologis pasien. Karena, penilaian penampilan estetik sangat subjektif, kami mengumpulkan data persepsi estetik pasien Fournier gangrene yang telah dilakukan prosedur STSG menggunakan Visual Analog Scale.Tujuan: Mendapatkan data mengenai persepsi estetik terhadap pasien Fournier GangreneMetode: Residen bedah plastik, pasien Fournier gangrene dan pasangannya diberikan foto pasien Fournier gangrene yang telah menjalani prosedur STSG. Mereka memberikan nilai bedasarkan VAS. Kami menanyakan apakah ada keluhan tambahan pada pasien.Hasil: Dari Januari 2011 hingga Agustus 2019, didapatkan 91 pasien Fournier gangrene di RSHS. Kami melakukan seleksi pada pasien menggunakan kriteria inklusi dan eksklusi dan mendapatkan 11 pasien. Hampir semua pasien menyatakan bahwa hasil prosedur STSG secara estetik baik, mean 8,10 (SD 0,74). Sedangkan semua residen bedah plastik dan pasangan dari pasien memberikan nilai yang baik atas hasil operasi, mean 8,36 (SD 0,50) dan 8,22 (SD 0,62). Tidak ada pasien yang mengeluhkan keluhan tambahan setelah prosedur STSG.Kesimpulan: Tiap kelompok penelitian memiliki latar belakang yang berbeda, namun didapatkan hasil persepsi estetik yang sama (baik) atas prosedur STSG tersebut.

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ABSTRACTBackground: Reconstruction of Fournier Gangrene patient is required functional and aesthetic appearance for psychological reasons. However, aesthetic perfection varies greatly and depends on subjective perception. Methods: Plastic Surgery residents, Fournier gangrene patients and their spouses are given the photos of patients after STSG. They made score based on VAS. We also asked for any complaints after the procedure.Aim: Provide database regarding aesthetic perception of Fournier gangrene patient after STSG.Result: From January 2011 until August 2019, there is 91 fournier gangrene patients at Hasan Sadikin hospital. We got 11 patients after selecting those using inclusion and exclution criteria. Almost all patients claimed that the aesthetic result after STSG procedure were good, the mean value were 8,10 (SD 0,74). While, all off the plastic surgery residents and the spouses of the patients argued that the aesthetic outcome of Fournier gangrene patients after STSG procedure were good. The mean value were 8,36 (SD 0,50) and 8,22 (SD 0,62). All of the patients didnt complaint any additional complaint.Conclusion: While each subject group has different background, we got same aesthetic perception from all groups (good result)."

"Kejadian anak dengan fraktur merupakan kasus terbanyak ketiga dalam tiga bulan terakhir. Selain itu, anak dengan post operasi fraktur jarang diberikan terapi nyeri non farmakologi. Hal tersebut menjadikan dasar tujuan karya ilmiah ini untuk memberikan asuhan keperawatan pada anak dengan fraktur dan STSG. Anak dengan post operasi fraktur dan STSG memerlukan intervensi untuk mengatasi nyeri. Intervensi yang dilakukan adalah memberikan terapi nyeri non farmakologi menggunakan teknik relaksasi napas dalam. Nyeri pada anak dikaji menggunakan skala numerik dengan skala 1-10. Anak dilatih teknik relaksasi napas dalam saat anak tidak nyeri. Teknik relaksasi napas dalam dengan istilah "tiup-tiup" dilakukan secara berulang-ulang ketika anak merasa nyeri. Istilah "tiup-tiup" ini efektif digunakan untuk mengingatkan anak ketika sedang merasa nyeri. Hasil penerapan dari intervensi yang telah dilakukan pada anak post operasi fraktur dan STSG dengan diagnosa keperawatan nyeri akut yaitu nyeri teratasi dibuktikan dengan adanya penurunan skala nyeri dari skala 6 ke skala 2.

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Children fracture was third biggest cases in third month ago. Beside that, child with post op fracture and STSG infrequently was given non farmacologic pain theraphy. The purpose of this study was to give nursing care in children with fracture and STSG. Children with fracture and STSG need intervention for pain. This intervention wcould be given with non farmacologic pain theraphy, used breat relaxation. Pain can be assased by numeric rating scale 1-10. Child was gived exercise breat relaxsation if the children not feel in pain. Breat relaxsation with terminology "tiup-tiup" was gived repeatedly which child having pain. This terminology "tiup-tiup" was effective for child to remember it, when the children were in pain. The results of application the interventions in children with post operatif fracture and STSG, pain can be proved a decrease in pain scale from 6 to 2."

"Deteksi dini kelainan vaskularisasi pada flap kulit memerlukan metode pemantauan yang konstan dan dapat diandalkan. Evaluasi melalui fotografi digital dapat menjadi solusi apabila didapatkan foto dengan spesifikasi seragam. Tujuan dari penelitian ini adalah mengembangkan prototipe studio foto portable yang mampu memberikan kualitas foto standard yang disebut sebagai Mini Mobile Medical Photo Studio (MiniMoPS) kemudian dilakukan analisa foto untuk memperoleh data dasar warna dan tekstur kulit hidup dan kulit kadaver. Pembuatan MiniMoPS dilakukan melalui studi literatur dan percobaan yang sesuai dengan kaidah foto studio. MiniMoPS kemudian digunakan untuk pengambilan sampel foto. Studi pendahuluan ini melibatkan 32 foto punggung tangan yang terdiri dari 16 foto kulit sehat dan 16 foto kulit kadaver. Hasil foto digital ini kemudian dianalisa menggunakan Adobe® Photoshop CS6 and ImageJ® freeware untuk mendapat nilai hue, saturasi, kecerahan, masing-masing komponen warna (merah, hijau dan biru) serta tekstur. Hasil foto tersebut menunjukkan nilai untuk kulit hidup adalah hue 33o, saturasi 13.75%, kecerahan 49.5%, Total Digital Number (TDN) 121.58 dan indeks tekstur 120 sementara kulit kadaver memiliki nilai hue 32.813o, saturasi 31.063%, kecerahan 68.188%, TDN 153.95 dan indeks tekstur 155.41. Hasil analisa menunjukkan kulit hidup memiliki warna lebih terang dan tekstur lebih homogen dibandingkan dengan kulit kadaver.

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Flap vitality monitoring remains a challenge for microvascular surgeons. Photo evaluation is potential but should produce a standard photo quality. This study propose the use of a portable photo studio called the Mini Mobile Medical Photo Studio (MiniMoPS) to produce consistent photographs and further analysed the photos to obtain a benchmark data of living and cadaveric skin colour and texture. The MiniMoPS was developed through a preliminary study to accommodate the basics elements of a photo studio. A pilot study was done, with 32 photographs of the dorsum of the hand, 16 from healthy samples and 16 from cadaveric samples. The digital photographs were analyzed using Adobe® Photoshop CS6 and ImageJ® freeware to obtain a quantification of hue, saturation, brightness, colour component (red, green and blue) and texture. Average value of living skin is hue 33o, saturation 13.75%, brightness 49.5%, Total Digital Number (TDN) 121.58 and 120 texture index while cadaveric skin has the following values; hue 32.813o, saturation 31.063%, brightness 68.188%, TDN 153.95 and 155.41 texture index. A significant difference was found between the two groups except for hue. Cut off points for TDN are generated with the range of 122–150. Analysis revealed that living skin gives a comparatively lighter colour and less coarse texture than cadaveric skin. The author proposed a TDN cut off point of 140 for validation in further studies."

"Latar belakang: Penelitian ini bertujuan untuk menilai adanya perbedaan nilai quality of life (QoL) dan time trade-off utility (TTO), pasca tindakan bedah katarak pada mata pertama dan mata kedua pada penduduk Lombok, Indonesia.Metode: Data epidemiologis dan penilaian QoL dan TTO didapat dari subjek, sebelum dan tiga minggu setelah menjalani tindakan bedah katarak pada sarana bedah komunitas di Pulau Lombok. Kelompok A adalah pasien yang menjalani operasi pada mata pertama, sedangkan kelompok B adalah pasien yang menjalani operasi pada mata kedua. Pertanyaan kuesioner ditujukan untuk mendapatkan data kemampuan mengurus diri sendiri, kemampuan mobilitas, kehidupan sosial, dan status mental. Data dianalisis dengan uji chi-square untuk data kategorik dan uji t tidak berpasangan atau Mann-Whitney untuk data numerik.Hasil: Data didapat dari 77 subjek, yang terdiri dari 50 subjek dari kelompok A dan 27 subjek dari kelompok B. Pasca bedah didapatkan adanya peningkatan QoL dalam hal kemampuan mengurus diri sendiri, kemampuan mobilitas, kehidupan sosial, dan status mental yang bermakna (p < 0,001), pada kedua kelompok. Peningkatan QoL terjadi pada 46 subjek di kelompok A, dan lebih meningkat lagi pada 22 subjek di kelompok B. Pengukuran TTO dapat diterima oleh 35 subjek pada kelompok A dan 22 subjek pada kelompok B. Delapan puluh tujuh persen subjek menyatakan hasil operasi yang sesuai dengan harapan mereka.Kesimpulan: Tindakan bedah katarak pada mata kedua terbukti dapat lebih meningkatkan QoL pada subjek dengan hasil penglihatan mata pertama yang baik. Peningkatan kemampuan penglihatan pasca bedah telah sesuai dengan harapan para subjek.

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AbstractBackground: This study aims to assess the quality of life and the time trade off-utility value of the first eye cataract surgery and the second eye cataract surgery in Lombok Island-Indonesia.Methods: This was an epidemiologic survey study on community of cataract surgery. Evaluations of quality of life (QoL) and time trade-off (TTO) were performed using questionnaire prior and three weeks after cataract surgeries who had either first (group A) or second eye cataract surgery (group B). Personal data was noted especially on self-care, mobility, socially, and mentally status. Data was analyzed by chi-square test for categorical data and unpaired t-test or Mann-Whitney test for numeric data.Results: A total of 77 subjects was included in this study, there were 50 subjects in group A and 27 subjects in group B. Elements of QoL were improved after surgeries including self care, mobility, social, and mental status in both groups (p < 0.001). The modified TTO was accepted in 35 subjects in group A and 22 subjects in group B. Quality of life was improved in 46 patients in group A, there was further improvement in 22 patients in group B. The degree of patient?s expectation was good in 87% of all subjects.Conclusion: Second- eye cataract surgery showed further improvement in QoL despite better outcome of the first- eye cataract surgery. The outcome of cataract surgery conducted was relevant to the patient?s expectation."

"Latar belakang. Kejadian demam pascabedah jantung sering ditemukan akibat tindakan pembedahan maupun penggunaan mesin pintas jantung paru (PJP), demam tersebut sulit dibedakan antara demam akibat infeksi atau inflamasi. Penegakan diagnosa infeksi dengan pemeriksaan kultur membutuhkan waktu lama dan kadang tidak tumbuh bakteri. Prokalsitonin (PCT) diharapkan sebagai penanda infeksi tanpa harus menunggu hasil kultur. Tujuan. Penelitian ini bertujuan menilai kadar PCT dapat membedakan demam infeksi dengan demam inflamasi pada pascabedah jantung. Metode. Penelitian ini dikerjakan di Unit Pelayanan Jantung Terpadu RSCM, dengan subyek pasien dewasa pascabedah jantung terbuka dengan menggunakan mesin PJP diikuti selama lima hari adanya demam dengan suhu ≥ 37,8° C, tanda dan gejala infeksi. Semua subyek diperiksa PCT dan kultur darah sebelum pembedahan, hari pertama, kedua dan kelima pascabedah. Pemeriksaan kultur dikerjakan atas indikasi klinis adanya infeksi. Hasil. Sebanyak 59 subyek pascabedah jantung menggunakan mesin PJP, terdapat dua subyek dropout (meninggal pada hari pertama dan kedua), 22 (37,28%) tidak demam, 32 (54,24%) demam inflamasi dan 5 (8,48%) demam infeksi. Infeksi ditemukan dari kultur sputum (Klebsiella pneumonie), hasil kultur darah, luka operasi, dan urin tidak ditemukan pertumbuhan bakteri. Didapatkan kadar PCT demam infeksi 13,48 ng/ ml dan demam inflamasi 6,90 ng/ ml. Simpulan. Kadar PCT demam infeksi (13,48 ng/ ml) lebih tinggi daripada demam inflamasi (6,90 ng/ ml). Tidak ada beda kadar PCT demam infeksi dan demam inflamasi secara statistik dengan p adalah 0,371.

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Background. Post cardiac surgery fevers usually caused by surgery itself or cardiopulmonary bypass (CPB). Difficulties to differentiated fever caused infection or inflammation. Bacterial culture to prove infections take a long time and sometimes the result is negative. Procalcitonin is sugested infection marker without wait for culture.

Goal. The aim of this study is to know procalcitonin level can differentiate fever cause infectious or inflammation.

Methods. This study performed at Integrated Cardiovascular Unit in RSCM, on adult patients who had open cardiac surgery with CPB, observed for temperature ≥ 37,8° C, sign and symptoms of infections, for 5 days. PCT levels and blood culture performed before surgery, first, second and 5th day after surgery. Culture from other sites performed as indicated.

Results. There are 59 have cardiac surgery with CPB, There are two subject dropout (died on 1st and 2nd days), 22 had no fever (37,28%), 32 had inflammation fever (54,24%) and 5 had infectious fever (8,48%). Infection confirmed by bronchial wash culture (Klebsiella pneumonie), no surgical wound infection, blood and urine culture were negative. We have PCT levels infectious group 13,48 ng/ ml and inflammation group 6,90 ng/ ml.

Conclussion. PCT levels infectious group (13,48 ng/ ml) higher than inflammation group (6,90 ng/ ml). Non parametric diagnostic Mann Whitney U test there are no significant differences of PCT levels between infectious and inflammation group, p=0,371."

"[ABSTRAK Obesitas menjadi perhatian khusus bagi ahli bedah karena selain menjadi faktor risiko keganasan payudara juga berperan penting dalam proses penyembuhan dan peningkatan komplikasi pasca mastektomi salah satunya adalah seroma Obesitas menyebabkan insiden pembentukan seroma lebih tinggi pasca MRM Berbagai penelitian telah dilakukan untuk melihat hubungan antara obesitas dengan produksi seroma namun didapatkan hasil kontroversial Oleh karena itu dilakukan penelitian ini untuk melihat korelasi obesitas dengan produksi seroma produksi seroma dengan lamanya perawatan Penelitian retrospektif potong lintang ini dilakukan dengan melihat kelengkapan data rekam medis pasien keganasan payudara unilateral di Departemen Medik Ilmu Bedah Fakultas Kedokteran Universitas Indonesia ndash RSUPN Cipto Mangunkusumo selama selama periode 2013 2014 Penelitian dilakukan terhadap 67 subjek dengan hasil rerata usia pasien keganasan payudara 48 5 8 5 tahun rerata IMT 25 43 4 08 kg m2 lama rawat inap 3 8 hari dan rerata produksi seroma total selama pasien dirawat 502 3 207 8 mL Pada penelitian ini didapatkan korelasi linier positif antara IMT dan produksi seroma total dengan peranan IMT terhadap produksi seroma total selama rawat inap dengan peranan IMT terhadap seroma 33 8 r 0 581 p ABSTRACT Obesity becomes one of particular concern for the surgeon because in addition to being a risk factor for breast carsinoma also important in the healing process and increase complications after mastectomy one of them is seroma Insidence seroma higher in obese then non obese patient after MRM Various study have been conducted to evaluate association between obesity and seroma production but the result is still controversial Hence this study was conducted to evaluate correlation between obesity and seroma production and also seroma production and long hospitalization All of the patient that was hospitalization in Cipto Mangunkusumo Hospital since 2013 until 2014 March was evaluated retrospectively This cross sectional study was being done toward 67 samples with age mean 48 5 8 5 years BMI mean 25 43 4 08 kg m2 length of stay 3 8 days and total seroma production mean 502 3 207 8 mL This study reported correlation linier positive between obesity and seroma production with role of obesity to seroma production is 33 8 r 0 581 p;Obesity becomes one of particular concern for the surgeon because in addition to being a risk factor for breast carsinoma also important in the healing process and increase complications after mastectomy one of them is seroma Insidence seroma higher in obese then non obese patient after MRM Various study have been conducted to evaluate association between obesity and seroma production but the result is still controversial Hence this study was conducted to evaluate correlation between obesity and seroma production and also seroma production and long hospitalization All of the patient that was hospitalization in Cipto Mangunkusumo Hospital since 2013 until 2014 March was evaluated retrospectively This cross sectional study was being done toward 67 samples with age mean 48 5 8 5 years BMI mean 25 43 4 08 kg m2 length of stay 3 8 days and total seroma production mean 502 3 207 8 mL This study reported correlation linier positive between obesity and seroma production with role of obesity to seroma production is 33 8 r 0 581 p, Obesity becomes one of particular concern for the surgeon because in addition to being a risk factor for breast carsinoma also important in the healing process and increase complications after mastectomy one of them is seroma Insidence seroma higher in obese then non obese patient after MRM Various study have been conducted to evaluate association between obesity and seroma production but the result is still controversial Hence this study was conducted to evaluate correlation between obesity and seroma production and also seroma production and long hospitalization All of the patient that was hospitalization in Cipto Mangunkusumo Hospital since 2013 until 2014 March was evaluated retrospectively This cross sectional study was being done toward 67 samples with age mean 48 5 8 5 years BMI mean 25 43 4 08 kg m2 length of stay 3 8 days and total seroma production mean 502 3 207 8 mL This study reported correlation linier positive between obesity and seroma production with role of obesity to seroma production is 33 8 r 0 581 p]"