Irwansyah, Denny
Yayasan Lingkar Studi Bedah Plastik

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The Role of STSG and Delayed Midline Approximation In Abdominal Wall Reconstruction Irwansyah, Denny; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol 1 No 2 (2012): March - April Issue
Publisher : Yayasan Lingkar Studi Bedah Plastik

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jpr.v1i2.41

Abstract

Acquired abdominal wall defects can result from previous surgery, trauma, infection and tumor resection. Complex abdominal wall defects challenge both general and plastic reconstructive surgeons. Skin grafting of abdominal viscera was originally described by Horton in 1953, demonstrated in dogs that STSG placed on the parietal peritoneum of abdominal viscera and buried in the peritoneal cavity would take well and survive. In 1994, Baker and Millard Jr reported serial cases of abdominal midline wound dehiscence which was treated with two stage abdominal wall reconstruction.Data was taken from medical and surgical records of patients consulted to the plastic surgery division with and acquired abdominal defect. We are reporting, Male, 42 yo, previous history of Perforated appendicitis with general peritonitis. We performed 2 stage reconstruction of abdominal wall for this patient.Treatment for an abdominal defect is selected on the basis of several factors, including the medical status of the patient, wound bed preparedness, depth, size and location of the defect. The goals of  abdominal reconstruction are restoration of function and integrity of the musculo-fascial abdominal wall, prevention of visceral eventeration and provision of dynamic muscle support.Skin grafting and delayed midline approximation are one of the reconstructive option available and deserve to be considered in the high risk, septic patient without compromising the patient final reconstructive result.
The Non-denuded Mucoperiosteal Palatoplasty Technique in Precipitating Healing Process of Palatal Lateral Defect Irwansyah, Denny; Bangun, Kristaninta; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol 1 No 3 (2012): May-June Issue
Publisher : Yayasan Lingkar Studi Bedah Plastik

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jpr.v1i3.70

Abstract

Background: Conventional two-flap palatoplasty technique which is a very common technique used including in our center, will result in lateral defects without any periosteal coverage. In this conventional technique, epithelialization of lateral defect was achieved within 3-4 weeks. These denuded lateral defects are prone to contamination and infection. The wound healing process in these wound will involve wound contraction, trigger scar formation, and will result in maxillary growth impairment. In our center, the retrospective study showed that conventional two-flap palatoplasty technique resulted in a fair maxillary growth (mean Goslon score=3.5). Thus, we explore other technique, which is non-denuded mucoperiosteal palatoplasty technique. We intend not to elevate all layers of mucoperiosteal flap in order to gain lateral defect covered by a thin sub-mucosa and periosteal layer. We assume that this technique will precipitate the re-epithelialization process. Faster re-epithelialization is expected to decrease wound contraction thus reducing scar formation, and in the long run will result in good maxillary growth. Method: Total 48 patients with unilateral or bilateral cleft palate were divided into 2 groups. Twenty-four patients underwent the non-denuded mucoperiosteal technique (intervention group) and another 24 patients underwent the conventional two-flap palatoplasty technique (control group). Evaluation of lateral defect closure was done in both groups and compared statistically. Result: Faster epithelialization was significantly influenced by age, WBC count and non-denuded mucoperiosteal technique.Summary: The non-denuded mucoperiosteal technique, along with age and WBC count, significantly accelerate the process of epithelialization of lateral defect post palate repair.
Acromiocervical Flap As One of the Modality To Reconstruct Post-Burn Neck Contracture: A Case Report Irwansyah, Denny; Sandhi, Afriyanti; Heryadi, Eko; Sudjatmiko, Gentur
Jurnal Plastik Rekonstruksi Vol 1 No 4 (2012): July-August Issue
Publisher : Yayasan Lingkar Studi Bedah Plastik

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jpr.v1i4.78

Abstract

Abstract: Postburn neck contractures are frequent and may cause gross facial deformity and severe functional disability. Reconstruction of these deformities is challenging, especially to plastic surgeon. Several methods have been published including skin graft, local flap and free flap. Patient and Method: The case presented in this paper is a postburn neck contracture which had been managed by two plastic surgeons in two different hospitals. This deformity limits the normal function of eating, speaking and appearance of this patient. Skin graft was used to correct this deformity but in the next few months neck contracture recurred. Result: It results in minimal disability and in overall improved functional and appearance outcome. We report our experience using the acromiocervical flap on a case for reconstruction of neck contracture with a goal to prevent recurrence.Summary: Skin Grafting is not an easy and simple procedure for reconstruction of the neck contracture. It requires comprehensive rehabilitation program including prolonged neck splinting and patient compliance. Considering those difFIculties acromiocervical flap can be one of the modality to reconstruct post burn neck contracture because it is relatively simple and reliable.