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 WELCOME TO  JURNAL REKONSTRUKSI DAN ESTETIK    Faculty of Medicine, Universitas Airlangga    ISSN International Center  |   p-ISSN:2301-793...

JURNAL REKONSTRUKSI DAN ESTETIK VOL.6 NO.2 DECEMBER 2021

SUBGLOTTIC STENOSIS (SGS) PASCA TRAUMA INHALASI


Managing Subglottic Stenosis (SGS) After Inhalation Trauma: Insights and Best Practices

Subglottic Stenosis (SGS) is a significant complication following inhalation trauma, occurring in a substantial number of patients post-intubation. This condition results from scar tissue formation and narrowing of the subglottic airway, often exacerbated by factors related to intubation. Research indicates that Laryngotracheal Stenosis (LTS), which includes SGS, affects 24-53% of patients after inhalation trauma, with complications and mortality rates varying.

A patient presented with extensive facial and extremity burns following an explosion in a confined space. Nine hours post-trauma, the patient experienced breathing difficulties and underwent intubation with a 6.5 mm cuffed Endotracheal Tube (ETT). Unfortunately, the cuff pressure was not monitored. After 38 days, the patient reported hoarseness and occasional breathing difficulties. Fiber Optic Laryngoscopy (FOL) revealed 30% subglottic narrowing, and the patient was diagnosed with Stage 1 SGS, which did not require surgical intervention and was managed with observation.

Results:

  • Early Evaluation Importance: Early FOL evaluation is crucial after inhalation trauma to detect SGS early.
  • Impact of Intubation Practices: SGS risk is increased by factors such as prolonged intubation, high cuff pressures, and multiple intubations. Recommended cuff pressure is 20-30 cmH2O, and it should be regularly monitored and adjusted.
  • Risk Factors: The severity of inhalation injury, inflammation level, and ETT size play critical roles in the development of SGS.

The case highlights the importance of proper intubation techniques to prevent SGS. Early and frequent evaluation using FOL is essential for timely detection and management. Adhering to recommended cuff pressure ranges and using appropriately sized ETTs can help mitigate risks. Proper monitoring of cuff pressures and avoiding unnecessary intubations are key strategies in preventing serious subglottic complications.

Preventing Subglottic Stenosis after inhalation trauma involves careful intubation practices, including using small-sized ETTs and maintaining appropriate cuff pressures. Early evaluation with FOL and adherence to best practices in intubation can significantly reduce the risk of developing SGS and improve patient outcomes.

Explore more about effective management strategies for SGS and enhance your knowledge on best practices for intubation and airway management.




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JURNAL REKONSTRUKSI DAN ESTETIK VOL.6 NO.2 DECEMBER 2021

EFEKTIVITAS PEMBERIAN KAPSUL EKSTRAK CHANNA STRIATA TERHADAP KADAR ALBUMIN PADA KASUS LUKA BAKAR



Effectiveness of Channa Striata Extract Capsules on Albumin Levels in Burn Wounds

Burn injuries represent a significant medical challenge, often resulting in severe complications such as hypoproteinemia due to the loss of albumin. Albumin, a key protein in maintaining blood volume and pressure, is frequently depleted in burn patients due to increased capillary permeability and fluid loss. Traditional methods of addressing hypoproteinemia include albumin transfusions, which are costly and not always feasible. This study evaluates the potential of Channa striata extract capsules as an alternative to enhance albumin levels and accelerate wound healing.

Burn wounds cause extensive damage to the skin and underlying tissues, leading to inflammation and vasodilation. This process increases capillary permeability, resulting in the loss of fluid and proteins, including albumin, into the extracellular space. This loss contributes to hypoproteinemia, which complicates the recovery process. Given the high cost and limited availability of albumin transfusions, there is a need for cost-effective and efficient alternatives. Channa striata extract, derived from the giant snakehead fish, is emerging as a potential solution due to its reputed benefits in wound healing and protein synthesis.

This study utilized a systematic review approach, analyzing data from journals accessed through Google Scholar and ScienceDirect. The focus was on evaluating the impact of Channa striata extract capsules on albumin levels and wound healing in burn patients.

Results:

  • Improved Albumin Levels: Analysis of five studies indicated that Channa striata extract significantly increases albumin levels in the blood.
  • Accelerated Wound Healing: The extract was shown to speed up the healing process of burn wounds.
  • Reduction in Oxidative Stress: The capsules effectively lower serum MDA levels, indicating reduced oxidative stress, and enhance nitrogen balance positively.

Channa striata extract offers a promising alternative to traditional albumin transfusions by improving albumin levels and supporting faster wound healing. The extract's ability to reduce oxidative stress and positively influence nitrogen balance further supports its effectiveness. Given its potential to enhance recovery while being more cost-effective than albumin transfusions, Channa striata extract presents a valuable option for managing burn injuries.

Channa striata extract capsules show considerable promise in increasing albumin levels and expediting wound healing for burn patients. The findings from this review highlight the extract's role as a beneficial supplement in burn care, offering an economically viable alternative to costly albumin transfusions. Future studies and clinical trials will be essential to confirm these benefits and establish standardized treatment protocols.

Explore how Channa striata extract can support burn recovery and improve patient outcomes.

🔗 Learn More: https://doi.org/10.20473/jre.v6i2.31835

🔗 More Articles: https://e-journal.unair.ac.id/JRE/


#BurnWoundCare #ChannaStriata #HealingPower #AlbuminBoost #HealthInnovation #MedicalResearch #jreunair

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JURNAL REKONSTRUKSI DAN ESTETIK VOL.6 NO.2 DECEMBER 2021

EVALUASI KASUS KARSINOMA SEL BASAL DI MAKASSAR PERIODE JANUARI 2017-DESEMBER 2019

Evaluation of Basal Cell Carcinoma Cases in Makassar: January 2017 - December 2019

Basal Cell Carcinoma (BCC) is the most common form of skin cancer, accounting for approximately 75% of all non-melanoma skin cancer cases. Despite its high prevalence, BCC typically has a favorable prognosis, especially when managed appropriately. This study aims to evaluate BCC cases in Makassar over a three-year period, providing valuable insights into its demographic trends, treatment methods, and outcomes.

BCC is a prevalent skin cancer that often manifests as a localized, slow-growing tumor. While rarely life-threatening, it can lead to significant local tissue damage if not treated early. This research focuses on BCC cases diagnosed from January 2017 to December 2019, with the goal of assessing patterns in diagnosis, treatment, and follow-up outcomes.

This retrospective descriptive study analyzed BCC cases from medical records at RS Wahidin Sudirohusodo, Universitas Hasanuddin, and Ibnu Sina in Makassar. Using total sampling, data were collected and compared with previous studies to identify trends and outcomes.

This study know that:

  • Patient Demographics: Out of 49 cases, 67.3% were female with an average age of 60 years. The majority of cases (51%) occurred in individuals aged 41-60 years.
  • Common Locations and Types: The nose was the most frequently affected site (30.6%). The nodular type was the most common histological variant (53.1%), while the morpheaform type was the least common (2.4%).
  • Treatment and Outcomes: A significant majority of patients (85.7%) underwent tumor excision. Metastasis was rare, observed in only five cases; two cases spread to the lungs, and one to the liver. Recurrence rates were low, with 81.6% of cases not showing signs of recurrence.

The study confirms that BCC predominantly affects the nasal region and that the nodular type is the most frequent. Surgical excision remains the preferred treatment method, with a high success rate and minimal recurrence. The rarity of metastasis underscores the generally favorable prognosis of BCC when treated promptly.

BCC in Makassar is characterized by a high incidence in the nasal region and a predominance of the nodular type. Treatment through tumor excision is effective, with low recurrence rates and minimal metastatic spread. This study contributes valuable data to the understanding of BCC trends in our region, supporting ongoing efforts in early detection and effective management.

For more details and in-depth analysis, read the full study here:


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JURNAL REKONSTRUKSI DAN ESTETIK VOL.6 NO.2 DECEMBER 2021

UPPER LIP VERMILION TRANSPOSITION FLAP PADA COMMISUROPLASTY DAN Z PLASTY PADA REKONSTRUKSI MACROSTOMIA

Upper Lip Vermilion Transposition Flap in Commissuropla
sty and Z-Plasty in Macrostomia Reconstruction

Macrostomia, a rare congenital anomaly occurring in approximately 1 in 80,000 births, presents unique challenges in facial reconstruction. This condition, often associated with other congenital disorders, necessitates precise surgical techniques to achieve optimal functional and aesthetic outcomes. In recent practices, combining Upper Lip Vermilion Transposition Flap with Z-Plasty has shown promising results in addressing macrostomia.

Macrostomia involves an abnormal enlargement of the oral commissure, which can affect the symmetry and function of the mouth. Traditional reconstructive methods have varied, but recent advancements aim to provide more standardized and effective solutions. The Upper Lip Vermilion Flap and Z-Plasty represent a significant evolution in this field.

 In a recent case, a patient underwent macrostomia reconstruction utilizing the Kaplan technique for commissuroplasty. The upper lip vermilion was transposed to the lower lip, and the orbicularis oris muscle was sutured using the Boo-Chai technique for optimal function. Additionally, Z-Plasty was employed for skin closure.

The Upper Lip Vermilion Flap technique proved effective in creating a more natural and symmetric commissure. By transposing the upper lip vermilion to the lower lip vermilion, the commissure achieved a more harmonious appearance. The use of the Boo-Chai technique for muscle suturing ensured that the orbicularis oris muscle function was as close to normal as possible.

The Z-Plasty technique was crucial for skin closure, as it helped prevent lateral migration of the commissure, ensuring a stable and aesthetically pleasing result. This technique minimizes scarring and improves the overall appearance of the reconstructed area.

For macrostomia reconstruction, the combination of the Upper Lip Vermilion Flap and Z-Plasty techniques offers a highly effective approach. The Upper Lip Vermilion Flap provides a more natural commissure, while Z-Plasty ensures that the commissure remains properly aligned with minimal scarring. The Boo-Chai suturing technique further enhances muscle function, contributing to a successful and aesthetically pleasing outcome.

These advanced techniques highlight the ongoing evolution in surgical approaches for macrostomia, offering improved results and enhanced patient satisfaction.

Learn more about these innovative techniques and their impact on facial reconstruction.

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JURNAL REKONSTRUKSI DAN ESTETIK VOL.6 NO.2 DECEMBER 2021

MICROAUTOLOGOUS FAT TRANSPLANTATION (MAFT) SEBAGAI REKONSTRUKSI LANJUTAN PADA KASUS DEFORMITAS MAKSILOFASIAL PASCA TRAUMA


Microautologous Fat Transplantation (MAFT) as a Continuation Reconstruction Method for Post-Traumatic Maxillofacial Deformities

In the realm of advanced facial reconstruction, Microautologous Fat Transplantation (MAFT) is emerging as a highly effective solution for addressing maxillofacial deformities, particularly those resulting from trauma. This innovative technique offers a promising approach for enhancing facial contours and correcting post-surgical imperfections.

Microautologous Fat Transplantation (MAFT) represents a modern evolution in fat transfer technology. While fat transfer techniques have been practiced since 1893, challenges related to fat resorption often necessitated multiple procedures. MAFT has advanced these techniques by significantly improving fat retention and minimizing the need for repeated interventions.

Consider a 39-year-old female patient who presented with hollow cheeks and asymmetric lips following an accident. She had previously undergone surgery by a plastic and reconstructive surgeon at RS Siloam to address a Zygomaticomaxillary Complex (ZMC) fracture and facial lacerations. The initial treatment involved repositioning and fixation with miniplates and screws, followed by wound closure.

To address the residual deformities, MAFT was employed. Fat was harvested using a 60 cc syringe with negative pressure, centrifuged at 3000 rpm for 10 minutes to separate fat from plasma, and then transplanted into the facial areas using the MAFT Gun. The distribution included 3.5 ml under the eyes, 20.5 ml in the cheeks, 3 ml in the chin, and 1 ml in the temples.

The procedure lasted 2.5 hours under moderate sedation and regional nerve blocks. Post-operatively, the patient exhibited significant improvement in facial contour. Follow-up after three months showed minimal fat resorption, and the aesthetic outcome was satisfactory. MAFT effectively addressed the facial deformities, making it a viable alternative for correcting maxillofacial deformities post-repositioning and fixation.

MAFT represents a promising technique for enhancing facial aesthetics, rejuvenating facial features, and correcting deformities caused by maxillofacial fractures. The procedure is minimally invasive and utilizes fat from various body areas with excess adipose tissue. By employing a certified MAFT Gun, the fat transfer process achieves high accuracy and consistency.

For those seeking a refined solution for facial reconstruction, MAFT offers an advanced and effective approach to achieving natural-looking results with minimal follow-up procedures.

Learn more about how MAFT can transform your facial contours and restore your confidence.

🔗 Learn More: https://doi.org/10.20473/jre.v6i2.31832
🔗 More Articles: https://e-journal.unair.ac.id/JRE/



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