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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