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"ABSTRAKRinoplasti adalah prosedur estetik yang banyak diminati di seluruh dunia dan merupakan prosedur menantang bagi seorang ahli bedah estetik karena memiliki satu tujuan yaitu kepuasan. Kepuasan ini tidak hanya untuk pasien, tapi juga bagi ahli bedah yang terlibat. Banyak faktor yang dapat mempengaruhi suatu kepuasan. Kepuasan yang ingin dicapai dapat dilihat dari segi estetik tanpa melupakan fungsinya. Penelitian ini menggunakan kuesioner rhinoplasty outcomes evaluation untuk menilai tingkat kepuasan pasien setelah menjalani prosedur rinoplasti. Segala jenis prosedur operasi, kususnya dibidang estetik, kunci keberhasilan adalah ketepatan pemilihan pasien, sehingga mengetahui psikologi pasien dapat menjadi garis depan dalam pengambilan keputusan pemilihan pasien. Prosedur ini memiliki risiko potensial tinggi terutama pada pasien dengan gangguan psikopatologi, sehingga penilaian psikologi pasien perlu dilakukan, dimana digunakan penilaian dengan skala kecemasan pada penelitian ini untuk mengetahui hal tersebut. Hal lain yang dapat mengurangi tingkat kepuasan pasien adalah keluhan sumbatan hidung setelah operasi, oleh karena itu penilaian aliran udara hidung sebelum dan sesudah operasi perlu dilakukan untuk memaksimalkan target kepuasan yang ingin dicapai. Oleh karena itu pada penelitian ini menggunakan kuesioner NOSE dan ESS, serta pemeriksaan PNIF untuk menilai aliran udara hidung sebelum dan sesudah operasi.

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ABSTRACTRhinoplasty is an aesthetic procedure that is in great demand throughout the world and is a challenging procedure for an aesthetic surgeon because it has one goal, satisfaction. This satisfaction is not only for patients, but also for the surgeons involved. Many factors can influence satisfaction. Satisfaction to be achieved can be seen in terms of aesthetics without forgetting its function. This study used a rhinoplasty outcomes evaluation questionnaire to assess the level of patient satisfaction after undergoing a rhinoplasty procedure. All types of surgical procedures, especially in the aesthetic field, the key to success is the accuracy of patient selection, so knowing the psychology of patients can be the front line in making patient selection decisions. This procedure has a high potential risk especially in patients with psychopathological disorders, so assessment of patient psychology needs to be done, which is used to assess the neurotic scale in this study to find out this. Another thing that can reduce the level of patient satisfaction is a complaint of nasal obstruction after surgery, therefore an assessment of nasal air flow before and after surgery needs to be done to maximize the target of satisfaction to be achieved. Therefore in this study using the NOSE and ESS questionnaire, and PNIF examination to assess nasal air flow before and after surgery.

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"[Latar belakang: Tujuan studi ini adalah untuk menilai persepsi masyarakat terhadap hasil operasi hidung pada pasien cleft menggunakan tehnik semi-open modified Tajima. Mengingat banyak tehnik operasi yang digunakan dengan berbagai kelebihan masing – masing, kami ingin mengetahui apakah tehnik yang sederhana, mudah dikerjakan dengan morbiditas yg rendah hasilnya akan mendapatkan apresiasi yang berbeda oleh orang tua dan para profesional medis.Metode: Studi cross sectional menggunakan questionnaire dengan menilai 25 foto dari hasil operasi hidung pada pasien cleft dengan tehnik semi-open modified Tajima. Duapuluh lima orang tua dan 25 orang pelaku medis dalam hal ini residen bedah plastik akan di perlihatkan foto, dan kemudian mereka akan menilai hasil operasi tersebut dengan menggunakan VAS score, yaitu berupa tanda disepanjang garis berukuran 100 mm. Data kemudian dianalisa dengan tes Chi-square. Dan korelasi antara profesional medis dan orang tua akan dianalisa menggunakan Spearman correlation.Results: Dari penelitian didapatkan perbedaan yang significant dari persepsi orangtua mengenai hasil operasi dengan professional medis sebesar -0.38 yang berarti persepsi mereka cenderung bertolak belakang. Dan terdapat korelasi lemah antara orangtua dan medis sebesar 0. 045(lebih rendah dari 0.05).Kesimpulan: Persepsi estetik antara profesional medis dan orangtua ternyata berbeda. Dan korelasi antara persepsi yang satu dengan yang lainnya ternyata lemah. Sebagai orang terdekat dan yang bertanggung jawab terhadap pasien, memang sudah sewajarnya kita mendengarkan dan menelaah apa sebenarnya keinginan dan harapan mereka. , Background: There are many technique of cleft rhinoplasty has been used worldwide. Each of it came with their advantage and disadvantage. Technique that has been known with simple, easy and less morbidity are semi – open modified Tajima technique, but it always judged as a second class compare to the open rhinoplasty, despite the higher morbidity of the open rhinoplasty. But actually no one ever try to find if result of the semi –open rhinoplasty modified Tajima technique are really dislike by the community. Are the medical professional communities whom prefer sophisticated technique with exquisite result or the parents also share the same interest? The different perception between medical profesional and parents are the thing we like to observe. Methods: A cross sectional research on a 25 consecutive sample for each grouup. Twenty-five photograph of a patient that has been through rhinoplasty using semi – open modified Tajima technique are shown to 25 parents and 25 medical professional (plastic surgery resident). After observe the photograph, parents and residents are giving their judgment on a questionnaire using VAS score. They put a mark on a 100 mm ruler base on their judgments. After that the result was analyzed using chi square, and correlation between parents and residents are analyzed using Spearman correlation. Results: The result shown that there are 12 poor perception and 13 good perception from medical professional, while there are 13 poor perception and 12 good perception from parents. There 6 poor perceptions by both medical professional and parents, and 6 good perceptions by booth parents and medical professional. A kappa value from this research is – 0.38, which means the two observers classify Background: There are many technique of cleft rhinoplasty has been used worldwide. Each of it came with their advantage and disadvantage. Technique that has been known with simple, easy and less morbidity are semi – open modified Tajima technique, but it always judged as a second class compare to the open rhinoplasty, despite the higher morbidity of the open rhinoplasty. But actually no one ever try to find if result of the semi –open rhinoplasty modified Tajima technique are really dislike by the community. Are the medical professional communities whom prefer sophisticated technique with exquisite result or the parents also share the same interest? The different perception between medical profesional and parents are the thing we like to observe. Methods: A cross sectional research on a 25 consecutive sample for each grouup. Twenty-five photograph of a patient that has been through rhinoplasty using semi – open modified Tajima technique are shown to 25 parents and 25 medical professional (plastic surgery resident). After observe the photograph, parents and residents are giving their judgment on a questionnaire using VAS score. They put a mark on a 100 mm ruler base on their judgments. After that the result was analyzed using chi square, and correlation between parents and residents are analyzed using Spearman correlation. Results: The result shown that there are 12 poor perception and 13 good perception from medical professional, while there are 13 poor perception and 12 good perception from parents. There 6 poor perceptions by both medical professional and parents, and 6 good perceptions by booth parents and medical professional. A kappa value from this research is – 0.38, which means the two observers classify ]"

"ABSTRAKPembatalan operasi di RSK THT-Bedah KL Proklamasi, dilaporkan sebesar 17 di atas angka standar 5 . Pembatalan operasi memiliki dampak negatif yang besar kepada pasien, staf medis, dan rumah sakit sehingga perlu dilakukan analisa terhadap pembatalan operasi. penelitian ini bertujuan untuk mengetahui penyebab dan faktor yang berkontribusi terhadap pembatalan operasi. Pengumpulan data dilakukan dengan menggunakan data rumah sakit dan diskusi kelompok terarah. Data yang terkumpul dilakukan analisis univariat, analisis bivariat, analisis multivariat dan analisis konten. Dari 1.129 rencana operasi, ditemukan pembatalan operasi sebanyak 308 27 kasus disebabkan oleh keputusan pasien sebanyak 177 kasus 57 , keputusan rumah sakit karena penyebab klinis sebanyak 125 kasus 41 , dan keputusan rumah sakit karena penyebab non klinis sebanyak enam kasus kurang dari 2 . Faktor yang berkontribusi secara bermakna terhadap pembatalan operasi didalam penelitian ini adalah usia pasien, penanggung biaya operasi pasien, dan hari operasi. Disarankan untuk rumah sakit memberikan perhatian khusus kepada pasien yang berusia lebih lanjut, pasien yang menanggung biaya operasi sendiri atau keluarga, operasi yang dilaksanakan bukan pada hari libur, membentuk klinik pra bedah serta melakukan perbaikan alur prabedah, memperbaiki kebijakan terkait biaya, melakukan perbaikan berkelanjutan pada masalah pembatalan operasi dan pengelolaan data rumah sakit.

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ABSTRACTCancellation of surgery in RSK THT Bedah KL Proklamasi, reportedly 17 standard rate le 5 . Cancellation of surgery has a great negative impact to Patient, Medical Staff, and Hospital so it is necessary to analyze the cancellation of operation. This study aims to determine the causing and contributing factor of cancellation. Data collection was performed using hospital data and focus group discussion. The collected data were analyzed by univariate analysis, bivariate analysis, multivariate analysis and content analysis. The cancellation of surgery are 308 cases 27 from 1.129 plan of surgery was caused by the decision of the patient 177 cases, 57 , hospital decision due to clinical cause 125, 41 , and hospital decision due to non clinical cause 6 cases, 2 . Factors that contribute significantly to cancellation of surgery in this study are the age of the patient, payer of patient operation, and the day of surgery. It is recommended that hospitals pay special attention to older patients, patients without insurance, surgery on work day, establish a pre surgical clinic and improve pre surgical flow, improve cost related policies, make continuous improvements to surgery cancellation issues and hospital data management."

"Penelitian ini bertujuan menganalisis bagaimana hukum medis dan etika kedokteran itu berlaku di Indonesia mengatur operasi plastik, rekonstruksi wajah total dan hukum tanggung jawab dokter dan rumah sakit yang melakukan operasi rekonstruksi wajah, dengan menganalisis praktik total rekonstruksi wajah Pasien X yang dilakukan di RSUP dr Rumah Sakit Universitas Airlangga. Bentuk penelitian yang digunakan dalam penelitian ini adalah normatif penelitian yuridis dengan penelitian deskriptif. Secara hukum, operasi rekonstruksi wajah diatur dalam beberapa pasal yang tercantum dalam UU No. 36 tahun 2009 tentang Kesehatan. Dilihat dari kode etik kesehatan yang berlaku di Indonesia, praktik facial Rekonstruksi termasuk dalam pelayanan kesehatan kuratif, yaitu kegiatan dan / atau aserangkaian kegiatan medis yang bertujuan menyembuhkan penyakit. Dalam praktiknya total wajah rekonstruksi Pasien X, unsur kerusakan yang diderita pasien bukanlah a akibat kelalaian dokter karena dokter telah melaksanakan kewajibannya untuk berjuang untuk mengubah bentuk dan meningkatkan fungsi wajah Pasien X, sehingga menjadi dokter tidak bisa dimintai pertanggungjawaban dalam hukum perdata. Teori sentral paling tepat tanggung jawab digunakan dalam menentukan tanggung jawab rumah sakit atas tindakan rekonstruksi dokter dalam praktek rekonstruksi wajah, karena di operasi rekonstruktif, terutama kasus-kasus sulit memerlukan banyak ahli dari berbagai bidang disiplin ilmu, dan rumah sakit dapat menggunakan konselor dan dokter yang tidak terus berlatih di rumah sakit. Diperlukan peraturan yang memadai untuk mengatur rekonstruksi wajah sebagai diuraikan dalam Peraturan Pemerintah dan Peraturan Menteri Kesehatan.

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This study aims to analyze how the medical law and medical ethics apply in Indonesia regulating plastic surgery, total facial reconstruction and the legal responsibilities of doctors and hospitals that perform facial reconstruction surgery, by analyzing the total practice of facial reconstruction in Patient X which is carried out in RSUP from Hospital Airlangga University. The form of research used in this study is juridical normative research with descriptive research. Legally, facial reconstruction operations are regulated in several articles listed in Law No. 36 of 2009 concerning Health. Judging from the health code of ethics that applies in Indonesia, the practice of facial Reconstruction is included in curative health services, namely activities and / or a a series of medical activities aimed at curing diseases. In practice the total facial reconstruction of Patient X, the element of damage suffered by the patient is not due to the negligence of the doctor because the doctor has carried out his obligation to struggle to change the shape and improve the facial function of Patient X, so that becoming a doctor cannot be held accountable in civil law. The most appropriate central theory of responsibility is used in determining the hospital's responsibility for physician reconstruction actions in the practice of facial reconstruction, because in reconstructive surgery, especially difficult cases require many experts from various disciplines, and hospitals can use counselors and doctors who do not continue to practice in the hospital. Adequate regulations are needed to regulate facial reconstruction as described in Government Regulations and Minister of Health Regulations."

"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."

"This richly illustrated book covers all aspects of aesthetic facial surgery, from anatomy to the variety of procedures employed in facial surgery, including ancillary techniques such as chemical peel, laser, and facial fillers. Both newer techniques and variations on older approaches are carefully presented and discussed. In addition, preoperative care is analyzed, and detailed attention is devoted to problems related to HIV infection, anesthesia, complications, and psychological aspects. The contributors are all internationally acclaimed experts in the field. "

"Tujuan : Mengetahui apakah HTA Indonesia 2003 sudah berjalan di departemen bedah RSCM dan mengetahui pengeluaran pemeriksaan rutin yang mungkin bisa ditekan. Meningkatkan kemampuan pemeriksaan fisik dan memilih pemeriksaan prabedah lebih selektif dan efisien.Tempat : Rumah Sakit Cipto Mangunkusumo.Metodologi : Penelitian ini merupakan penelitian cross-sectional dan data disajikan dalam bentuk deskripif. Sebanyak 106 pasien diambil datanya dari status pasien yang masih dirawat (44 orang) dan dari status pasien rawat jalan (62 orang). Pengambilan subjek dengan consecutive sampling untuk yang masih dirawat dan acak sederhana pada pasien rawat jalan. Data yang dikumpulkan meliputi karakteristik pasien, sebaran penyakit/kelainan sitemik, sebaran pasien pra dan pascabedah, komplikasi pascabedah, permintaan foto toraks sesuai HTA dan rutin berikut biaya, penyakit sistemik yang mendasari pemeriksaan fate toraks, pemeriksaan darah rutin, pemeriksaan BTICT sesuai HTA dan rutin berikut biaya, pemeriksaan kimia darah sesuai HTA dan rutin berikut biaya, pemeriksaan foto torak dan darah sesuai HTA dan rutin.Hasil : Berdasarkan karakteristik pasien kelompok yang sehat lebih banyak dari pasien dengan kelainan sistemik. Penyakitlkelainan sistemik terbanyak adalah kardiopulmonal diikuti tuberculosis dan anemia. Prabedah dalam kondisi baik dan tidak ada komplikasi pasca bedah. Terdapat perbedaan foto toraks HTA dan rutin ( 21 dan 85 dengan biaya Rp.1.050.000 dan Rp.4.250.000). Terdapat perbedaan pemeriksaan BTICT HTA dan rutin (2 dan 104 dengan biaya Rp.30.000 dan Rp.1.560.000). Terdapat perbedaan pemeriksaan kimia darah HTA dan rutin dengan biaya Rp.2.175.000 dan Rp.6.993.500 dan pemeriksaan kimia darah dan foto toraks menurut HTA dan rutin: 7 dan 99 dengan biaya Rp 2.525.000 dan Rp 12.803.500.Kesimpulan : Pemeriksaan prabedah sesuai HTA belum berjalan.pemeriksaan rutin masih dominan dengan selisih biaya tiga sampai enam kali lebih mahal dari pemeriksaan sesuai HTA dan juga tidak efisien karena tidak terdapat komplikasi pascabedah.

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Objective: The aim of this study was to know whether HTA Indonesia 2003 had been performed in the department of surgery RSCM and to know how much its cost for the preoperative routine examination. To improve physical examination and selective choosing preoperative examination based on physical findings.

Place: Cipto Mangunkusumo Hospital

Method: The design was descriptive and cross-sectional retrospective study. There was 44 patients in the ward room and 62 patients at out patience clinics all taken from the status. The sample was taken with consecutive sampling for patients who still in the ward and simple random for patients at out patients clinics. Data collected were characteristics of the patients, systemic diseases, preoperative and postoperative, complications, chest x-ray according HTA and routine with its cost, chest x-ray with systemic diseases, routine blood test, coagulation test, blood chemistry test routine and HTA, blood test and chest x-ray routine and HTA.

Results: Most patients were in good conditions. Sistemic disesase were cardiopulmonal, tuberculosis, and anemia_ Preoperative were in good conditions and there were no complications. There were differences between HTA and routine chest x-ray (21 and 85 with the cost Rp 1.050.000 and Rp 4.250.000), HTA and routine coagulation test were 2 and 104 with the cost Rp 30.000 and Rp 1.560.000, HTA and routine blood chemistry test were Rp.2.175.000 and Rp.6.993.000, HTA and routine chest x-ray and blood chemistry test were 7 and 99 with cost Rp 2.525.000 and Rp 12.803.500.

Conclusions: HTA preoperative examination had not been performed yet, routine preoperative test were dominant and were cost three and six times more expensive than HTA. There were no complications postoperatively, so routine preoperative test should be considered."