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"[ABSTRAKLatar Belakang Fiksasi Mandibulomaksila merupakan tindakan prosedur bedah yang harus dikuasai oleh residen bedah plastik untuk menjadi seorang ahli bedah plastik berhubungan dengan semakin bertambah banyaknya kasus kasus dibidang kraniofasial Dengan melakukan pelatihan pada model mandibulomaksila residen tersebut diharapkan akan memiliki kemampuan dan kompeten untuk melakukan prosedur tersebut sebelum berhadapan langsung dengan pasien yang sebenarnya Pelatihan ini berupa program pelatihan menggunakan model mandibulomaksila untuk mengevaluasi efeknya dalam meningkatkan keterampilan dan kemampuan residen bedah plastik dalam menghadapi kasus kasus di bidang kraniofasial Metoda Dua puluh dua orang residen bedah plastik diikutsertakan dalam pelatihan ini mereka dibagi menjadi dua grup grup pertama terdiri atas residen bedah plastik yang belum pernah mengerjakan prosedur fiksasi mandibulomaksila sebelumnya dan grup kedua terdiri atas residen bedah plastik yang sudah pernah mengerjakan prosedur ini sebelumnya Mereka menjalani satu set program pelatihan yang terdiri dari satu sesi pembekalan materi dan satu sesi pelatihan pada model Kemudian mereka dievaluasi dalam hal kemampuan keterampilan fiksasi mandibulomaksila Sesi pelatihan pada model direkam menggunakan video dan dinilai oleh dua orang ahli bedah plastik konsultan kraniofasial sebagai evaluator Hasil ABPAS dan IMFscrew placement Global Rating Scale menunjukkan peningkatan skor performa pada studi populasi yang lebih berpengalaman group 2 pada seluruh aspek termasuk the task specific work list 16 5 2 44 vs 18 1 57 P 0 19 global rating scale 17 5 2 63 vs 19 4 2 31 P 0 43 total ABPAS score 33 9 4 76 vs 37 4 3 82 P 0 34 dan juga untuk IMFscrew placement global rating scale 14 9 1 53 vs 15 9 0 95 P 0 38 walaupun hasil pengumumannya tidak menunjukkan hasil yang bermakna secara statistik Waktu yang dibutuhkan untuk menyelesaikan arch bar 48 min 17 s vs 41 min 8 s P 0 23 Waktu yang dibutuhkan untuk menyelesaikan IMFscrew 9 min 25 s vs 6 min 32 s P 0 23 Waktu total untuk menyelesaikan seluruh tugas lebih singkat pada group 2 walaupun perbedaannya tidak bermakna secara statistik 57 min 24 s vs 47 min 17 s P 0 23 Kesimpulan Program pelatihan Fiksasi MandibuloMaksila telah terbukti dapat membantu residen bedah plastik untuk meningkatkan keterampilan kraniofasial mereka memberikan hasil berupa peningkatan skor performa ABPAS dan IMFscrew placement Global Rating Scale dan waktu yang lebih singkat dalam menyelesaikan seluruh tugas Kata kunci pelatihan fiksasi mandibulomaksila test bedah plastik keterampilan kraniofasial arch bar.

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ABSTRACTBACKGROUND Mandibulomaxillary fixation MMF is one of the surgery skill a plastic surgery resident have to master to become a plastic surgeon as craniofacial cases increase rapidly By doing training on a non living model one will be competent to do the skill prior to face the real patient This study implement a training program using cranial model to evaluate the increasing learning curve in craniofacial cases among residents in training METHODS Twenty two plastic surgery residents were enrolled in this study they were divided into two groups the first group consists of residents who never perform this skill before and the second group were the ones who have performed this skill previously They performed a set of training consisting of one knowledge based session followed by one skill based session Afterwards they were evaluated in terms of maxillomandibular fixation skills ability using ABPAS and IMFscrew placement Global Rating Scale which assessed by two senior craniofacial surgeons using video recording RESULTS The ABPAS and IMFscrew placement Global Rating Scale demonstrated an increase of performance score in the more experienced study population group 2 in all aspect including the task specific work list 16 5 2 44 vs 18 1 57 P 0 19 global rating scale 17 5 2 63 vs 19 4 2 31 P 0 43 total ABPAS score 33 9 4 76 vs 37 4 3 82 P 0 34 and also for IMFscrew placement global rating scale 14 9 1 53 vs 15 9 0 95 P 0 38 although the measurement did not show statistically significant results Time needed for arch bar completion 48 min 17 s vs 41 min 8 s P 0 23 Time needed for IMFscrew placement completion 9 min 25 s vs 6 min 32 s P 0 23 Total time to task completion was shorter in group 2 although the difference was not statistically significant 57 min 24 s vs 47 min 17 s P 0 23 CONCLUSION The MandibulloMaxillary Fixation training program have proven to help plastic surgery residents in training to increase their craniofacial skills give an increase in ABPAS and IMFscrew placement Global Rating Scale performance score and shorter time to task completion KEYWORDS mandibulomaxillary fixation MMF training plastic surgery testing learning curve for craniofacial arch bar, BACKGROUND Mandibulomaxillary fixation MMF is one of the surgery skill a plastic surgery resident have to master to become a plastic surgeon as craniofacial cases increase rapidly By doing training on a non living model one will be competent to do the skill prior to face the real patient This study implement a training program using cranial model to evaluate the increasing learning curve in craniofacial cases among residents in training METHODS Twenty two plastic surgery residents were enrolled in this study they were divided into two groups the first group consists of residents who never perform this skill before and the second group were the ones who have performed this skill previously They performed a set of training consisting of one knowledge based session followed by one skill based session Afterwards they were evaluated in terms of maxillomandibular fixation skills ability using ABPAS and IMFscrew placement Global Rating Scale which assessed by two senior craniofacial surgeons using video recording RESULTS The ABPAS and IMFscrew placement Global Rating Scale demonstrated an increase of performance score in the more experienced study population group 2 in all aspect including the task specific work list 16 5 2 44 vs 18 1 57 P 0 19 global rating scale 17 5 2 63 vs 19 4 2 31 P 0 43 total ABPAS score 33 9 4 76 vs 37 4 3 82 P 0 34 and also for IMFscrew placement global rating scale 14 9 1 53 vs 15 9 0 95 P 0 38 although the measurement did not show statistically significant results Time needed for arch bar completion 48 min 17 s vs 41 min 8 s P 0 23 Time needed for IMFscrew placement completion 9 min 25 s vs 6 min 32 s P 0 23 Total time to task completion was shorter in group 2 although the difference was not statistically significant 57 min 24 s vs 47 min 17 s P 0 23 CONCLUSION The MandibulloMaxillary Fixation training program have proven to help plastic surgery residents in training to increase their craniofacial skills give an increase in ABPAS and IMFscrew placement Global Rating Scale performance score and shorter time to task completion KEYWORDS mandibulomaxillary fixation MMF training plastic surgery testing learning curve for craniofacial arch bar]"

"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."

"The human skull is a complicated structure made up from 20 constituent bones and it is thus not suprising that the pattern of growth is complicated. The fully grown skull is not simply a larger version of the inflant form. The adult skull differs not only in size but also in shape, indicating that there must be a process of differential growth. The differential growth process must be a differential activity seen in the craniofacial skelet, during the growing period and it may be divided into four component. Knowledge of craniofacial growth provides a background to the understanding of the treatment planning process and to undertake suitable interceptive treatment to hinder the stomatognathic function problems in the future."

"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."

"Latar Belakang: Pergeseran dominasi antara laki-laki dan perempuan pada dunia kedokteran terjadi dari waktu ke waktu di berbagai belahan dunia, termasuk di bidang bedah plastik di Indonesia. Profesi yang semula didominasi oleh laki-laki, saat ini didominasi perempuan. Pergeseran dominasi perempuan ini memungkinkan terjadinya masalah-masalah yang berpengaruh pada pendidikan dan pelayanan bedah plastik. Penelitian ini bertujuan untuk mengeksplorasi fenomena dominasi perempuan pada pendidikan spesialis di Indonesia. Metode: Penelitian ini bersifat kualitatif berupa studi fenomenologi. Penelitian dilakukan pada 3 program pendidikan dokter spesialis bedah plastik rekonstruksi dan estetik di Indonesia. Penelitian dimulai pada bulan Januari 2020. Populasi penelitian terdiri dari 4 kelompok, yaitu peserta didik, dosen, pengelola program studi, dan pengguna lulusan. Responden penelitian dipilih menggunakan metode maximum variation sampling. Setiap responden mendapatkan informed consent, seluruh informasi yang diberikan sifatnya rahasia dan tidak memengaruhi proses pendidikan responden. Metode pengumpulan data berupa studi dokumen, Focus Group Discussion (FGD), dan In-Depth Interview. Data penelitian yang diperoleh dari berbagai metode diatas, kemudian dianalisis dan diolah lebih dalam secara tematik. Hasil: Peneliti membagi tema berdasarkan garis waktu proses pendidikan, yaitu: prapendidikan, intra-pendidikan, dan pascapendidikan. Masing-masing proses memiliki tema yang saling memengaruhi proses pendidikan. Pada masa prapendidikan terdapat karakter personal yang dipengaruhi oleh persepsi positif maupun negatif dari masyarakat. Sedangkan iklim lingkungan kerja, dampak dominasi perempuan, dan dimensi budaya memengaruhi kelancaran intra-pendidikan. Pasca pendidikan dan memasuki dunia kerja, peserta didik menginginkan suatu kondisi lingkungan kerja yang ideal dan terdapat preferensi tempat bekerja tertentu untuk mencapai kondisi well-being. Kesimpulan: Dampak dominasi perempuan selama pendidikan hanya akan berpengaruh pada dinamika kehidupan antar peserta didik dan antara peserta didik dengan dosen sebagai mentor. Namun dominasi ini tidak akan memengaruhi kualitas pendidikan dan beban kerja yang diberikan. Pada penelitian ini juga didapatkan fenomena kesenjangan kepemimpinan tidak terjadi selama pendidikan tetapi terjadi pada pascapendidikan. Namun kesenjangan kepemimpinan bukanlah akibat tekanan dalam komunitas, melainkan kecenderungan dari pribadi perempuan pada umumnya di kelompok masyarakat feminim.

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Introduction: Shifting in gender dominance between men and women in the medical field has occurred from time to time globally, including in Indonesia’s plastic surgery. The profession, which was initially dominated by men, is currently dominated by women. This shift in female dominance might allow problems that affect the education and clinical settings of plastic surgery. This study aims to explore the phenomenon of women's dominance in medical residency education in Indonesia. Method: This study is a qualitative study of phenomenology. It was conducted on 3 medical residency programs specializing in reconstructive and aesthetic plastic surgery in Indonesia. The study began in January 2020. The research population consisted of 4 groups, namely students, lecturers, study program managers, and graduate users. Research subjects were selected using the maximum variation sampling method. Each respondent was provided with informed consent, all information given was confidential and did not affect the educational process of the respondent. Data collection methods include document study, Focus Group Discussion (FGD), and In-Depth Interview. Research data obtained from various methods above was analyzed and processed thematically. Results: The themes were categorized based on the educational process timeline, namely: pre-education, intra-education, and post-education. Each timeline had several themes which mutually influenced the educational process. During pre-education there were personal characters which were affected by positive and negative perceptions from society. Whereas the work environment atmosphere, the impact of women's dominance, and the cultural dimension affected the intra-educational process. After graduating from residency program and entering the career life, students expected an ideal working environment and had certain workplace preferences to achieve their well-being. Conclusion: The impact of women's dominance during education affected the daily dynamics among students and their interaction with lecturers as mentors. However, this dominance did not affect the quality of education and workload. We also found that the phenomenon of leadership disparity did not occur during education but occurred in post-education setting. This leadership disparity was not resulted by pressure in the community, but due to the tendency of the women’s personality in general among the feminine community."

"ABSTRAK Penatalaksanaan Fistel Enterokutan masih sangat beragam dan sulit dengan tingkat kekambuhan dan kematian pasca pembedahan yang masih tinggi. Tujuan dari penatalaksanaan pasien dengan fistel enterokutan adalah koreksi defisit metabolik dan nutrisi, penutupan fistel dan mengembalikan kesinambungan saluran cerna. Tujuan dari penelitian ini adalah untuk melakukan evaluasi penatalaksanaan bedah pada fistel enterokutan yang dirawat di RSUPN Cipto Mangunkusumo selama tahun 2014-2015. Penelitian ini dirancang secara retrospektif analitik dengan mengambil data rekam medik penderita di RSUPN Cipto Mangunkusumo pada periode 2014-2015. Ditemukan 27 kasus fistel enterokutan, dimana 21 kasus yang di evaluasi, rentang umur 27-65 tahun, terbanyak pada kelompok 40-60 tahun (52,38%), letak fistel terbanyak di ileum (57,14%), high output (71,43%), gizi buruk (52,38%), dilakukan tindakan operatif (85,71%), lama rawat <20 hari (66,67%), rekurensi fistel (19,05%) dan angka kematian (14,29%).ABSTRACT Management of enterocutaneous fistula still varies and frustrating with high recurrence and mortality rate. The goal of management for patient with enterocutaneous fistula are correct metabolic and nutritional deficits, close the fistula and reestablish continuity of the gastrointestinal tract. The purpose of this study was to evaluate the surgical management of the enterocutaneous fistula treated at Cipto Mangunkusumo Hospital during 2014-2015. This study designed analytic retrospectively by taking the patient medical record data at Cipto Mangunkusumo Hospital ini the period 2014-2015. Found 27 cases of enterocutaneous fistula which 21 cases were evaluated, age range 40-60 years (52,38%), the location of the fistula largest in the ileum (57,14%), high output (71,43%), malnutrition (52,38%), operative management (85,71%), length of stay in hospital <20 days (66,67%), fistula recurrence (19,05%) and mortality rate (14,29%).;Management of enterocutaneous fistula still varies and frustrating with high recurrence and mortality rate. The goal of management for patient with enterocutaneous fistula are correct metabolic and nutritional deficits, close the fistula and reestablish continuity of the gastrointestinal tract. The purpose of this study was to evaluate the surgical management of the enterocutaneous fistula treated at Cipto Mangunkusumo Hospital during 2014-2015. This study designed analytic retrospectively by taking the patient medical record data at Cipto Mangunkusumo Hospital ini the period 2014-2015. Found 27 cases of enterocutaneous fistula which 21 cases were evaluated, age range 40-60 years (52,38%), the location of the fistula largest in the ileum (57,14%), high output (71,43%), malnutrition (52,38%), operative management (85,71%), length of stay in hospital <20 days (66,67%), fistula recurrence (19,05%) and mortality rate (14,29%).;Management of enterocutaneous fistula still varies and frustrating with high recurrence and mortality rate. The goal of management for patient with enterocutaneous fistula are correct metabolic and nutritional deficits, close the fistula and reestablish continuity of the gastrointestinal tract. The purpose of this study was to evaluate the surgical management of the enterocutaneous fistula treated at Cipto Mangunkusumo Hospital during 2014-2015. This study designed analytic retrospectively by taking the patient medical record data at Cipto Mangunkusumo Hospital ini the period 2014-2015. Found 27 cases of enterocutaneous fistula which 21 cases were evaluated, age range 40-60 years (52,38%), the location of the fistula largest in the ileum (57,14%), high output (71,43%), malnutrition (52,38%), operative management (85,71%), length of stay in hospital <20 days (66,67%), fistula recurrence (19,05%) and mortality rate (14,29%)."

"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)."

"Program Operasi Katarak Gratis merupakan salah satu program kerja Dinas Kesehatan Kota Depok yang telah dilaksanakan sejak tahun 2004 dan pada tahun 2015 target program operasi katarak di Kota Depok tidak terpenuhi. Penelitian ini merupakan penelitian deskriptif kualitatif yang membahas tentang evaluasi program operasi katarak gratis di Kota Depok pada tahun 2015. Hasil penelitian menunjukkan bahwa tidak tercapainya target program operasi katarak gratis di Kota Depok disebabkan oleh kurangnya pelatihan yang diberikan kepada petugas kesehatan di masyarkat, kurangnya sosialisasi program operasi katarak gratis di masyarakat dan banyaknya masyarakat Kota Depok yang telah terdaftar menjadi pasien BPJS. Di era BPJS saat ini masyarakat yang terdaftar menjadi pasien BPJS tidak diperbolehkan mengikuti program operasi katarak gratis karena dapat berpotensi terjadinya pembiayaan ganda terhadap pasien tersebut.

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Free Cataract Surgery Program has been implemented since 2004 in Depok. However, in 2015 the target of cataract surgery program in Depok is not fulfilled. This study is a qualitative descriptive study with aim to evaluate the free cataract surgery program in Depok 2015. The results showed that the target of free cataract surgery program not fulfilled caused by the lack of training that given to health workers in the community, lack of socialization about free cataract surgery program, and majority of public who already have registered in BPJS. In BPJS era, people who have registered in BPJS are not allowed to register for free cataract surgery program because it would be a double burden for BPJS."

"Komite Medik RSU Karawang yang baru berusia satu tahun merupakan wadah non struktural yang melaksanakan tugas dan fungsinya sebagai pengendali kualitas pelayanan di rumah sakit, masih menghadapi berbagai kendala-kendala yang belum dapat terpecahkan. Dengan struktur ketenagaan, pembiayaan dan piranti lunak dari pimpinan rumah sakit, proses Komite Medik dapat berjalan, namun masih belum optimal, sehingga dampaknya tehadap outcome tindakan bedah, terutama terhadap kualitas pelayanan medik, belum terlihat. Masalah ini diakibatkan karena struktur yang mendukung, belum mecakup dukungan stuktural berupa sarana gedung dan peralatan yang memadai. Disamping itu prosedur tetap tentang kegiatan-kegiatan komite medik masih belum lengkap, sehinga proses belum dapat berjalan dengan optimal. Kaitannya dengan outcome tindakan bedah, oleh karena berdasarkan pengalaman di negara Amerika (Phartenon, 1979) 75% tuntutanmasyarakat pengguna yang diajukan terhadap dokter, 82% diantaranya ditujukan kepada para dokter yang melakukan tindakan pebedahan.Oleh Karena itu, diperlukan peningkatan peran manajemen rumah sakit, untuk turut serta mengupayakan pemecahan masalah yang dihadapi oleh komite medik dan untuk mencegah terjadinya tuntutan masyarakat pengguna, dengan cara perbaikan struktur dan proses komite medik yang pada akhirnya akan berdampak terhadap meningkatnya kualitas pelayanan (outcome).Penelitian ini bersifat studi kasus dengan pendekatan kualitatif, karena meneliti struktur proses dan outcome yang sudah memiliki pola. Fokus penelitian adalah komite medik, yang berkaitan dengan struktur, proses kegiatan komite medik, serta outcome dari tindakan bedah di RSU Karawang.Dari hasil penelitian, didapat suatu gambaran bahwa pengorganisasian komite medik berdampak positif terhadap struktur, proses dan outcome tindakan bedah, sehingga hasil penelitian ini dapat digunakan untuk membentuk suatu konsep pengembangan komite medik di Rumah Sakit Umum Daerah Unit Swadana Daerah kelas C Kabupaten Daerah Tingkat II Karawang. Konsep ini dibentuk berdasarkan tinjuan pustaka dan penelitian langsung di lapangan.Hasil ini merupakan masukan kepada manajemen rumah sakit, sebagai dasar dalam pengembangan Komite Medik.Daftar Pustka: 32 (1972 - 1995).

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Medical Staff Organization (MSO) is a functional unit in Karawang Hospital , with an objective to monitor and control the quality of medical services. This unit has been working since 1995, and still have a lot of problems in organizing is activities. This study is intended to compare structure, process and outcome of medical staff activities in Karawang Hospital, during the period of pre-MSO (1994) and post MSO (1995).The trigger initiating MSO activities in Karawang Hospital is the Director's decree (SK) on development of MSO in Karawang Hospital. The new MSO organization has a full support from the Hospital Director with facilities, financial supports and methods.MSO activities in 1995 was increasing very fast, with 36 MSO meeting where almost 80% of all the doctors present. Mortality evaluation meetings, morbidity meetings, nosocomial task force, statistical evaluation of quality of medical services, completeness of medical records suddenly become a medical concern in the hospital. MSO budget for meetings and training of medical staff jumped from 1,6 millions rupiah in 1994 to 7,7 millions in 1995 and projected to 50 millions in 1996. Result of the study shown that MSO was very active in 1995 compared to the situation in 1994.Outcome of MSO in this study is measured by the quality of medical surgeries conducted in 1994 and 1995. The study shown the decrease in waiting time for surgery, and length of stay after surgery in 1995 compared to 1994. Since mortality rate is influenced by the condition of patients when they came to the hospital, the outcome data should look further to the increasing rate of infection after surgeries. The study suggest to look at nosocomial infection, quality of nursing of patients facilities, and improvement of quality of medical services through the development of standard operating procedures for every surgeries in Karawang Hospital.The study concluded that MSO had a positive impact on the quality of medical surgeries in Karawang Hospital. One of the important finding of this study is that MSO will not working properly without a full support and attention of Hospital Director.Reeferences : 32 (1972 - 1995)."