COMPARATIVE OUTCOMES OF EARLY VERSUS DELAYED WOUND GRAFTING IN BURN PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

 

🔥 Does Timing Matter in Burn Wound Grafting? Evidence from a Meta-Analysis

Burn injuries remain a major global health burden, with more than 265 million cases annually worldwide. Surgical skin grafting is a cornerstone in burn management, yet the optimal timing of grafting, whether early or delayed continues to be debated, especially in settings with limited resources.

This systematic review and meta-analysis published in Jurnal Rekonstruksi dan Estetik (JRE) evaluates the clinical and functional outcomes of early versus delayed wound grafting in burn patients.

📄 Article Title:
Comparative Outcomes of Early Versus Delayed Wound Grafting in Burn Patients: A Systematic Review and Meta-Analysis
🔗 DOI: https://doi.org/10.20473/jre.v10i2.75022

📌 Why This Study Matters

Early excision and grafting,traditionally performed within 48 hours to 7 days is believed to:

• Reduce infection risk

• Shorten hospital stay

• Improve functional recovery

• Lower morbidity and mortality

However, factors such as hemodynamic instability, inadequate resuscitation, and limited surgical resources often delay intervention, particularly in low- and middle-income countries. This study provides evidence-based guidance to support clinical decision-making.

🔍 Methods at a Glance

• Study design: Systematic review and meta-analysis

• Search period: July 2024 – January 2025

• Study types included:

  • Randomized controlled trials

  • Cohort studies

  • Observational studies

• Comparison groups:

  • Early grafting (within 3–7 days)

  • Delayed grafting (after 7 days)

• Outcomes assessed:

  • Length of hospital stay

  • Infection rates

  • Blood loss

  • Limb and hand function (TAM & grip strength)

📊 Key Results

• 250 studies identified, 7 studies met inclusion criteria

• Hospital stay:

  • Early grafting significantly reduced hospitalization by
    8.89 days
    (95% CI: −12.88 to −4.89)

• Functional outcomes:

  • Early grafting showed significantly better Total Active Movement (TAM)
    MD: 22.10 (95% CI: 17.95 to 26.24)

• Other outcomes:

  • No statistically significant differences between early and delayed grafting in:

    • Blood loss

    • Infection rates

    • Post-operative grip strength

🧠 Clinical Interpretation

✅ Early wound grafting offers clear benefits in:

• Faster recovery

• Shorter hospital stay

• Improved postoperative limb mobility

⚠️ However, early grafting did not significantly outperform delayed grafting in terms of infection rates or blood loss, highlighting the importance of patient condition and surgical readiness rather than timing alone.

🎯 Key Takeaways

• Early grafting improves functional recovery and hospitalization outcomes

• Timing should be balanced with patient stability and resource availability

• Supports early intervention when clinically feasible

• Calls for further high-quality studies to refine timing protocols

📚 Published in: Jurnal Rekonstruksi dan Estetik
✍️ Authors: Rafeni Bunga, Beta Subakti Nata’admaja
🏥 Affiliations:

• Mayapada Hospital Surabaya

• Dr. Soetomo General Academic Hospital, Surabaya

🔗 Read the full article:
https://doi.org/10.20473/jre.v10i2.75022

#BurnInjury #SkinGrafting #EarlyGrafting #DelayedGrafting #BurnManagement #ReconstructiveSurgery #PlasticSurgery #SystematicReview #MetaAnalysis #EvidenceBasedMedicine #FunctionalOutcome
 #WoundCare #HospitalStay #ClinicalDecisionMaking #JRE #JREUnair

THERAPEUTIC POTENTIAL OF SNAIL MUCUS IN WOUND HEALING : A SYSTEMATIC REVIEW AND META-ANALYSIS

 

✨ Exploring Snail Mucus as a Novel Bioactive Agent in Wound Repair

Wound healing is a complex biological process that requires a coordinated interaction between inflammation control, collagen synthesis, angiogenesis, and tissue remodeling. Despite advances in wound care, delayed healing remains a significant clinical challenge prompting ongoing exploration of natural bioactive substances that can support tissue regeneration.

A recent article published in Jurnal Rekonstruksi dan Estetik systematically evaluates the therapeutic potential of snail mucus extract as a wound-healing agent through a systematic review and meta-analysis of randomized controlled trials (RCTs).

📄 Article Title:
Therapeutic Potential of Snail Mucus in Wound Healing: A Systematic Review and Meta-Analysis
🔗 DOI: https://doi.org/10.20473/jre.v10i2.72008

📌 Why This Study Is Important

Proteins play a pivotal role in wound repair, mediating cellular migration, extracellular matrix formation, and tissue remodeling. Snail mucins, large glycosylated proteins found in snail mucus, have been reported to:

• Stabilize protein structures

• Enhance cell–cell recognition

• Modulate viscosity and solubility

• Promote collagen production

• Reduce inflammatory responses

This study provides a rigorous evidence-based evaluation of these proposed benefits.

🔍 Key Findings from the Meta-Analysis

🔹 Study Design and Methodology

• Meta-analysis of randomized controlled trials

• Databases searched:

  • PubMed

  • ProQuest

  • Web of Science

  • ScienceDirect

  • Scopus

  • EBSCOHost

  • ClinicalTrials.gov

• Methodological framework:

  • PRISMA guidelines

  • PICO framework

  • Quality assessment using the JADAD scale

🔹 Quantitative Results

• 3 RCTs (2021–2023)

• Total of 60 animal subjects (rats)

• Snail mucus group showed a significantly faster wound healing rate compared to controls:

  • Mean Difference (MD): −3.21%

  • 95% CI: −3.72 to −2.69%

  • P < 0.00001

These results indicate a robust and statistically significant effect.

🧬 Biological Mechanisms Behind Snail Mucus

The bioactive components of snail mucus contribute to wound healing by:

• Enhancing collagen synthesis

• Reducing local inflammation

• Supporting cellular proliferation and migration

• Improving tissue remodeling dynamics

These mechanisms align well with modern principles of regenerative medicine and biomaterial-based wound therapy.

⚠️ Translational Considerations

While the findings strongly support the wound-healing efficacy of snail mucus in animal models, the authors emphasize the need for:

• Well-designed clinical trials

• Standardized formulations

• Safety and dosage evaluations in humans

🎯 Why This Article Is Worth Reading and Citing

• Provides pooled quantitative evidence via meta-analysis

• Highlights snail mucus as a promising natural wound-healing agent

• Integrates molecular rationale with experimental outcomes

• Relevant to plastic surgeons, wound care specialists, and regenerative medicine researchers

• Opens avenues for future translational and clinical research

📚 Published in: Jurnal Rekonstruksi dan Estetik
✍️ Authors: Febe Alodia Widjaja et al.
🏥 Affiliations: Universitas Airlangga, Universitas Airlangga Hospital, Dr. Soetomo General Academic Hospital, University of Twente

🔗 Read the full article:
https://doi.org/10.20473/jre.v10i2.72008

#WoundHealing #SnailMucus #RegenerativeMedicine #NaturalBioactives #CollagenSynthesis
#InflammationControl #MetaAnalysis #SystematicReview #EvidenceBasedMedicine #PlasticSurgery
#ReconstructiveSurgery #WoundCare #BiomedicalResearch #TranslationalResearch #MedicalPublication #JRE #JREUnair

EFFECTIVENESS OF ANTIBIOTIC PROPHYLAXIS IN MAXILLOFACIAL TRAUMA SURGERY: A SYSTEMATIC REVIEW

 

✨ Reassessing Routine Antibiotic Use in Maxillofacial Trauma Surgery

Maxillofacial trauma surgery frequently involves contaminated wounds, complex anatomy, and prolonged operative time, factors traditionally associated with a higher risk of surgical site infections (SSIs). For this reason, antibiotic prophylaxis has long been prescribed as routine practice. However, growing concerns regarding antimicrobial resistance, unnecessary costs, and unclear clinical benefit have prompted critical re-evaluation of this approach.

A recent systematic review published in Jurnal Rekonstruksi dan Estetik addresses this ongoing debate by examining whether prophylactic antibiotics truly reduce SSI rates in maxillofacial trauma surgery.

📄 Article Title:
Effectiveness of Antibiotic Prophylaxis in Maxillofacial Trauma Surgery: A Systematic Review
🔗 DOI: https://doi.org/10.20473/jre.v10i2.72261

📌 Why This Study Matters

Despite widespread use, recommendations on whether, when, and how long antibiotics should be given in maxillofacial trauma surgery remain inconsistent. Overprescription not only increases healthcare costs but also contributes to the global threat of antimicrobial resistance.

This systematic review provides an evidence-based assessment to support more rational, patient-centered antibiotic use.

🔍 Key Findings from the Review

🔹 Study Design and Methodology

• Systematic search conducted using Google Scholar

• Selection based on PICO framework

• Included observational cohort studies

• Study quality assessed using the JBI Critical Appraisal Checklist for Cohort Studies

A total of six studies met the inclusion criteria.

🔹 Do Prophylactic Antibiotics Reduce SSIs?

• Five of six studies found no significant reduction in SSI rates with prophylactic antibiotics

• Lack of benefit observed regardless of:

  • Timing (preoperative vs postoperative)

  • Duration of antibiotic administration

• Only one study reported a statistically significant reduction in SSIs with preoperative prophylaxis

Variations in surgical technique, antibiotic regimens, patient characteristics, and study design likely contributed to inconsistent findings.

🔹 Postoperative Antibiotics: More Harm Than Benefit?

The review highlights that postoperative antibiotic regimens:

• Do not reduce SSI rates

• Increase treatment costs

• Contribute to antimicrobial resistance

These findings challenge the routine use of prolonged antibiotics after maxillofacial trauma surgery.

⚠️ Clinical Implications

Rather than universal prophylaxis, the evidence supports a selective, risk-based approach, reserving antibiotics for:

• Immunocompromised patients

• Grossly contaminated wounds

• Extensive soft-tissue injury

• Prolonged or complex surgical procedures

Such an approach aligns with modern principles of antibiotic stewardship and evidence-based surgical care.

🎯 Why This Article Is Worth Reading and Citing

• Clarifies controversies surrounding antibiotic prophylaxis in maxillofacial trauma

• Supports judicious and selective antibiotic use

• Reinforces antimicrobial stewardship principles

• Relevant for oral and maxillofacial surgeons, plastic surgeons, and trauma teams

• Highlights the need for high-quality randomized controlled trials

📚 Published in: Jurnal Rekonstruksi dan Estetik
✍️ Authors: Naufal Agus Isamahendra, Muhammad Tidar Abiyyu, Iswinarno Doso Saputro, Yanuar Ari Pratama
🏥 Institution: Faculty of Medicine, Universitas Airlangga & Dr. Soetomo General Academic Hospital

🔗 Read the full article:
https://doi.org/10.20473/jre.v10i2.72261

#MaxillofacialTrauma #AntibioticProphylaxis #SurgicalSiteInfection #AntimicrobialStewardship
#EvidenceBasedSurgery #MaxillofacialSurgery #PlasticSurgery #ReconstructiveSurgery #TraumaSurgery #InfectionControl #ClinicalResearch #SystematicReview #MedicalPublication
#GlobalHealth #PatientSafety #RationalAntibioticUse #AMR #HealthcareQuality #JRE #JREUnair

WOUND HEALING EFFICACY OF MOIST EXPOSED BURN OINTMENT (MEBO) AND SILVER SULFADIAZINE IN PARTIAL-THICKNESS BURNS: A SYSTEMATIC REVIEW

 

✨ Revisiting Topical Burn Care: Is MEBO a Better Alternative to Silver Sulfadiazine?

Burn injuries remain a significant global health challenge, often requiring prolonged wound care and posing risks of infection, delayed healing, scarring, and surgical intervention. For decades, silver sulfadiazine (SSD) has been widely used as the standard topical therapy for partial-thickness burns. However, growing concerns regarding delayed epithelialization and potential adverse effects have prompted clinicians to explore alternative treatments.

One such alternative is Moist Exposed Burn Ointment (MEBO), a plant-based topical agent originating from traditional Chinese medicine. But how does MEBO truly compare to SSD in terms of clinical effectiveness?

A recent systematic review published in Jurnal Rekonstruksi dan Estetik provides evidence-based answers to this question.

📄 Article Title:
Wound Healing Efficacy of Moist Exposed Burn Ointment (MEBO) and Silver Sulfadiazine in Partial-Thickness Burns: A Systematic Review
🔗 DOI: https://doi.org/10.20473/jre.v10i2.71980

📌 Why This Study Is Important

Topical agents play a crucial role in burn wound management, influencing healing time, infection rates, pain control, and the need for surgical intervention. Despite SSD’s long-standing use, its drawbacks have fueled interest in alternatives that promote faster and more physiological wound healing.

This systematic review synthesizes existing clinical evidence comparing MEBO and SSD, offering clinicians clearer guidance when choosing topical therapy for partial-thickness burns.

🔍 Key Insights from the Systematic Review

🔹 What Is MEBO?

MEBO is a herbal-based topical ointment containing:

• Sesame oil – moisture retention and barrier protection

• Beta-sitosterol – anti-inflammatory effects

• Berberine – antimicrobial properties

Together, these components create an optimal moist wound environment that supports natural epithelial regeneration.

🔹 Evidence from Clinical Trials

• Five clinical trials (2000–2008) were included

• Databases searched: PubMed, Cochrane, and ScienceDirect

• Keywords: MEBO, SSD, burns, wound healing

Across all included studies, MEBO demonstrated comparable or superior outcomes when compared with SSD.

🔹 Improved Wound Healing Outcomes with MEBO

Consistent findings showed that MEBO was associated with:

• Shorter wound healing time

• Reduced pain intensity

• Lower infection rates (negative wound swab cultures)

• Minimal slough and crust formation

• Fewer complications

• Reduced need for surgical intervention

These outcomes highlight MEBO’s ability to promote a more favorable healing environment in partial-thickness burns.

🌱 MEBO as a Natural, Patient-Friendly Alternative

Beyond clinical outcomes, MEBO offers additional advantages:

• Plant-based formulation

• Better patient comfort

• Supports moist wound healing principles

• Potentially reduces healthcare burden by minimizing surgical needs

🎯 Clinical Implications

The findings suggest that MEBO is not only an effective alternative but may be a preferable option for managing partial-thickness burn wounds, particularly in settings where optimizing healing time and patient comfort is a priority.

For burn units, plastic surgeons, and wound care specialists, this review supports the integration of MEBO into evidence-based burn management protocols.

📚 Why This Article Is Worth Reading and Citing

• Systematic comparison of MEBO and SSD in burn care

• Highlights advantages of plant-based topical therapy

• Reinforces modern moist wound healing concepts

• Useful for clinicians, burn specialists, and researchers

• Supports informed clinical decision-making

📚 Published in: Jurnal Rekonstruksi dan Estetik
✍️ Authors: Aditya Wardhana, Nadya Farhana
🏥 Institution: Burn Unit, Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia

🔗 Read the full article:
https://doi.org/10.20473/jre.v10i2.71980

#BurnCare #WoundHealing #PartialThicknessBurns #BurnInjury #BurnManagement #MEBO  #SilverSulfadiazine #TopicalTherapy #MoistWoundHealing #HerbalMedicine #PlantBasedTherapy
#ClinicalEvidence #SystematicReview #PlasticSurgery #ReconstructiveSurgery #BurnUnit #ClinicalResearch #EvidenceBasedMedicine #WoundCare #MedicalPublication #JRE #JREUnair

MICROSURGERY IN A TERTIARY HOSPITAL IN EAST KALIMANTAN: A FIVE-YEAR RETROSPECTIVE STUDY FROM PLASTIC SURGERY DIVISION

 

✨ Understanding the Landscape of Microsurgical Reconstruction Beyond Major Medical Hubs

Microsurgery has become a cornerstone of modern reconstructive surgery, enabling surgeons to restore complex soft-tissue defects that cannot be managed with conventional techniques. While such advanced procedures are well-documented in major academic centers, data from provincial referral hospitals—particularly outside Java—remain limited.

A newly published article in Jurnal Rekonstruksi dan Estetik sheds light on this critical gap by presenting the first comprehensive epidemiological overview of microsurgical cases in East Kalimantan.

📄 Article Title:
Microsurgery in a Tertiary Hospital in East Kalimantan: A Five-Year Retrospective Study from Plastic Surgery Division
🔗 DOI: https://doi.org/10.20473/jre.v10i2.78717

📌 Why This Study Matters

Strategic planning of reconstructive services depends on reliable data regarding patient characteristics, indications, surgical approaches, and outcomes. In regions with limited published evidence, such as East Kalimantan, service development often relies on assumptions rather than data-driven insights.

This study addresses that gap by analyzing five years of microsurgical practice at a provincial tertiary referral hospital, offering valuable perspectives for clinicians, hospital administrators, and health policy planners.

🔍 Key Findings at a Glance

🔹 Patient Demographics and Referral Patterns

• 31 microsurgical procedures performed in 28 patients

• Majority were male (64.5%)

• Predominantly adults aged 18–60 years (80.7%)

• Most patients were referred from Type B hospitals (61.3%), confirming the hospital’s role as a regional referral center

🔹 Complex Soft-Tissue Defects Dominate

• 93.5% of cases involved complex soft-tissue defects

• Leading etiologies included:

  • Malignancy

  • Post-burn contracture

  • Chronic wounds

  • Electrical trauma

These findings highlight the increasing burden of non-traumatic and oncologic reconstruction, extending beyond acute trauma cases.

🔹 Free Flap Reconstruction as the Mainstay

• All cases were managed using free flap transfer

• Overall success rate: 77.5%

• Most commonly used flap:

  • Anterolateral thigh (ALT) flap – 58.1%

• This reflects both surgeon preference and the versatility of ALT flaps in managing extensive defects

🏥 Clinical and System-Level Implications

The results demonstrate that functional microsurgical capacity is achievable at a provincial hospital, even outside major academic centers. However, the observed failure rate also emphasizes the need for:

• Improved perioperative monitoring

• Strengthened postoperative care systems

• Continued training and resource optimization

🎯 Why This Article Is Worth Reading and Citing

• First epidemiological study of microsurgical reconstruction in East Kalimantan

• Provides real-world outcome data from a provincial tertiary hospital

• Highlights the dominance of complex soft-tissue defects in clinical practice

• Supports evidence-based expansion of microsurgical services beyond trauma care

• Valuable for reconstructive surgeons, residents, hospital planners, and policymakers

📚 Published in: Jurnal Rekonstruksi dan Estetik
✍️ Authors: Devina Swantara, Andi Ardan, Yudhy Arius, Selmy Sabry Mohamed Awad

🔗 Read the full article:
https://doi.org/10.20473/jre.v10i2.78717

#Microsurgery

#ReconstructiveSurgery

#PlasticSurgery

#FreeFlap

#EastKalimantan

#SoftTissueReconstruction

#ClinicalOutcomes

#SurgicalEpidemiology

#HealthServicesResearch

#TertiaryHospital

#ProvincialHealthcare

#MedicalResearch

#NewPublication

#JRE

#JREUnair

MECHANISMS AND OUTCOMES OF 1470NM LASER THERAPY FOR VAGINAL REJUVENATION: A MULTI-OMICS OBSERVATIONAL STUDY

 

✨ Unlocking the Molecular and Clinical Evidence Behind 1470nm Laser Technology in Women's Regenerative Gynecology

Vaginal laxity, dryness, and diminished elasticity can significantly affect a woman’s quality of life, particularly after childbirth or during menopause. Modern regenerative gynecology increasingly embraces non-invasive laser-based therapies, but what exactly happens at the cellular and molecular level?

A new article published in Jurnal Rekonstruksi dan Estetik, titled: 

MECHANISMS AND OUTCOMES OF 1470NM LASER THERAPY FOR VAGINAL REJUVENATION: A MULTI-OMICS OBSERVATIONAL STUDY
(DOI: 10.20473/jre.v10i2.74266),
offers one of the most comprehensive data-driven explanations to date.

📌 Key Takeaways for Gynecologists, Regenerative Medicine Experts, and Clinical Researchers

🔹 First Multi-Omics Evidence for 1470nm Laser Mechanisms

The study presents the first integrated dataset combining:

• RNA sequencing,

• proteomics,

• metabolomics,
  revealing a consistent upregulation of genes and proteins related to collagen remodeling and angiogenesis.
  Notably, TGF-β signaling emerged as a central regulatory pathway in vaginal tissue regeneration.

🔹 Strong Clinical Outcomes Across 120 Women

In this prospective observational study involving women aged 25–65:

• Vaginal wall thickness increased 35% (p<0.001)

• Collagen density improved 42% (p<0.001)

• FSFI scores rose 28%

• 92% of participants reported better sexual satisfaction
  High-resolution ultrasound, OCT, and histopathology supported these findings.

🔹 Why 1470nm Laser Therapy Matters

This wavelength targets water-rich tissues with precision, enabling:

• collagen stimulation,

• neovascularization,

• enhanced elasticity,
  with minimal discomfort and no downtime making it a rising star in non-invasive regenerative gynecology.

🔹 A New Era of Personalized Vaginal Rejuvenation

By linking molecular mechanisms with real clinical outcomes, this study lays the foundation for:

• more personalized treatment plans,

• biomarker-based patient selection,

• and optimized therapy protocols.

🎯 Why This Study Is Worth Citing

• One of the first multi-omics studies in vaginal laser therapy.

• Provides mechanistic clarity behind widely used 1470nm technology.

• Bridges clinical practice with molecular science, rare in gynecologic rejuvenation research.

• Offers valuable data for clinicians, researchers, and medical device developers.

🔗 Read the full article here: https://doi.org/10.20473/jre.v10i2.74266

📚 Published in: Jurnal Rekonstruksi dan Estetik

✍️ Authors:  Smit Bharat Solanki, Deblina Dutta

#VaginalRejuvenation #LaserTherapy #1470nmLaser #RegenerativeGynecology
#WomenHealth #CollagenRemodeling #Angiogenesis #MultiOmics
#GynecologyResearch #ClinicalOutcomes #JREPublication #MedicalScience
#TGFbSignaling #ReconstructiveSurgery #NonInvasiveTherapy
#PatientCenteredCare #MedicalInnovation