Background: Over the past years, microvascular free tissue transfer has become increasingly popular in field of plastic surgery. Our center also been actively performing these complex surgeries for extensive defect closure. In this study spanning five our objective is to examine challenges commonly encountered flap reconstruction and identify factors that contribute failure such flaps, with ultimate goal enhancing learning curve.Methods: This article presents a retrospective analysis all...

Introduction: Microvascular reconstruction demands specialized and additional training beyond residency. This study investigates the free flap learning curve at a newly established microsurgery center by analyzing viability rate over 10 years. Methods: A retrospective review of procedures performed between 2014 2024 single microsurgeon National Referral Hospital, Indonesia, was to assess rates, types, relationships specific choices defect locations. The correlation cumulative also analyzed....

Background: The LYMPH-Q Upper Extremity module is a patient-reported outcome measurement tool developed by the Q-Portfolio team at McMaster University, Canada, and widely used to determine health-related quality of life patients with upper extremity lymphedema. However, translation these tools Indonesian language has not been attempted any institution. Methods: was performed according International Society Pharmacoeconomics Outcomes Research guidelines. steps included forward reconciliation,...

Background: The BREAST-Q reconstruction module, a patient-reported outcome measurement tool, is widely used to assess the impact of breast surgery on patient satisfaction and health-related quality life. However, translation Indonesian language has not been attempted or for Indonesian-speaking women with cancer. Methods: module was performed in accordance International Society Pharmacoeconomics Outcomes Research guidelines, which included forward reconciliation, back review, cognitive...

Background: Breast reconstruction in women with breast cancer has not been thoroughly investigated or measured Indonesia. A pioneering study is needed to identify the rate, treatment outcomes, and factors influencing a smaller population support nationwide epidemiological studies future. Methods: The secondary data of 105 who underwent post-breast surgery at several centers Jakarta were collected retrospectively from 2020—the first quarter 2024. Univariate bivariate analyses subsequently...

Abstract Background The complexity of plastic microsurgery yields many risks. Robot assistance has been sought to maximize outcome and minimize complications. Reportedly, it offers increased dexterity flexibility with attenuated human flaws, such as tremors fatigue. This systematic review will further investigate that claim. Methods A search was conducted for operative outcomes operator experience reconstructive compared between conventional robot-assisted procedures. Data were summarized...

The ideal dose for indocyanine green (ICG) has not been established yet, although 5 mg per mL is widely accepted free flap evaluation. Due to its high price and rarity in developing countries, this preliminary study aimed find the lowest concentration of ICG without reducing fluorescence quality read by near-infrared camera animal models. An experimental was conducted on 25 Wistar rats divided into five groups based injected ICG, which mL, 3.75 2.5 1.25 0.5 concentrations. epigastric...

Background: Assessing perfusion in free flaps is crucial clinical practice. Indocyanine green (ICG) angiography offers a more objective and reproducible method, utilizing near-infrared imaging to monitor flap vascularization. This study aims evaluate the efficacy of diluted ICG as tool for assessing perfusion. Methods: pilot randomized trial compares fluorescence concentrations at 3 different dilutions: 5 mg/mL (standard concentration), 2.5 (half standard 0.5 (one-tenth concentration)....

Plastic surgery in Indonesia was pioneered and developed by Moenadjat Wiratmadja, MD., 1958. This specialty experienced many developments improvements over time with more specific subspecialties to facilitate the advancement of science plastic surgery, including reconstructive microsurgery subspecialty. The service division dr. Ciptomangunkusumo National Hospital (RSCM), Jakarta, first initiated Sidik Setiamiharja, self-taught from textbooks. In late 1985, following success conducting basic...

Ocular injury is second mostly caused by motor vehicle accident (MVA) and often leads to severe ocular even visual loss various aesthetic problems. The outcome determined the magnitude of initial damage treatment availability. Treating facial due MVA challenging given scope may result in outcomes. This case presented a 22-years old woman with history car assessed total upper eyelid avulsion corneal perforation involvement multiple fractures on left side. function irreparable extensive defect...

Background: The long-term outcomes in pediatric patients with various extents of mandible defects have not been well-documented. Methods: A retrospective case series which this study looked at under the age 13 who had mandibular reconstruction free fibular flap and received another operation previous 6 months. eating, swallowing, speech function, quality life are evaluated EORTC QLQ-H&N35 after growth spurt has occurred. Results: total 7 were included ages ranging from years 1 month to...

Background: Neoadjuvant chemotherapy (NAC) is a crucial component in the management of tongue-based locally advanced squamous cell carcinoma (LASCC) due to its ability decrease tumor mass and facilitate free tissue transplantation. The utilization adjuvant radiation has been observed decelerate progression post-operative growth. Probability flap failure elevated. Post-operative complications long-term functional outcomes speaking, salivation, swallowing determine quality flaps. Methods: A...

This case addressed patient and free flap survival after cardiac arrest with the contentious use of vasopressors amid concerns about potential vasoconstrictive effects on vitality. A 59-year-old male mucoepidermoid carcinoma underwent post-total maxillectomy double reconstruction (free fibular anterolateral thigh flap). Intraoperatively, he experienced anastomosis due to hypovolemia or hypoxia, requiring external massage vasopressor administration. Despite initial restoration circulation,...

Introduction: Complex mandibular reconstruction is at risk of postoperative restricted mouth opening. Temporomandibular joint pseudoankylosis can cause significant disability, leading to opening and an inability create a proper seal with the mouth. Treating this condition often requires aggressive surgical intervention, primarily restoring structure functionality mandible. Coronoidectomy plays vital role in improving capacity. Case Presentation: Four patients temporomandibular were included...

Summary: In the context of tuberculous spondylitis, a rare form extrapulmonary tuberculosis causing significant discomfort and neurological deficits, surgery becomes imperative to alleviate symptoms alongside antituberculosis treatment. However, utilization free vascularized fibula flaps for repairing vertebral deformities remains uncommon. This report presents case 21-year-old man with limb weakness sensory disturbances who was referred our hospital, where contrast magnetic resonance...

Introduction: Multi-stages refinement of a bulky flap after composite defects reconstruction multiple facial units has been challenging situation. Goals including restoration periorbital and malar area redefining the aesthetic aspects as well surrounding nasolabial with refinements microfat graft. Methods: A 50-year-old male patient history solitary fibrous tumor underwent wide excision left periorbital, infraorbital, lateral nasal sidewall, area. The defect is enclosed Anterolateral Thigh...

Summary: The anterolateral thigh (ALT) flap is the with various components based on perforators from descending branch of lateral circumflex femoral artery. This has a number advantages and disadvantages. It can be used to reconstruct defects after oncologic resection coverage following amputation or preserve limb length. contraindications include unsuitable donor sites, inadequately debrided recipient morbid obesity. Preparations for ALT procedure consist history taking, physical...

Summary: Free fibular flap (FFF) is a composite consisting of bone and skin paddle. Muscle may be added to the flap. It has several advantages disadvantages. The free well suited for any reconstruction head neck. suitable defects anterior mandibular arch or lateral in patients who wish undergo osseointegrated dental reconstruction. Meanwhile, its contraindications are related significant atherosclerotic diseases patient congenital variants arteries. Preparations FFF procedure consist history...

Background: Central facial soft tissue defect poses a unique challenge for the reconstructive surgeon. The three-dimensional properties of aesthetic subunit and its related function are goals reconstruction. Considering prominent social role face, procedure to achieve good quality life patients may cost more than single surgery. This single-center study presents an algorithm treatment central it’s proposed classification according authors’ experiences. Methods: A retrospective review medical...

Nasal reconstruction has continued to advance in accordance with Menick's vision as it was first conceived. His combination of radial forearm free flaps the gold standard paramedian forehead is highly regarded for producing superior outcomes, and received widespread praise a consequence. In this study, we present nine patients who had nose using flaps. All successful outcomes. Using FACE-Q questionnaire, assessed degree which were satisfied both functional aesthetic aspects their appearance....

Abstract Background The advanced development of computer-assisted design/manufacturing (CAD/CAM) technology aids in the process producing patient-specific template for intraoperative dissection and fixation guide. To date, CAD/CAM has been greatly used reconstructive mandibular cases to enhance accuracy, reduce operation time, minimize possible complications. However, this was believed be cost- time-inefficient, limiting widespread use several institutions. Methods This study displayed five...


 To achieve an optimal result in cleft surgery, executing the proper designs and precise techniques are mandatory.
 Several proposed for repair of unilateral bilateral lip. In 1955, Millard !rst described advancing a lateral upper lip "ap combined with downward rotation medial segment.1 From experience, above- mentioned technique may be modi!ed to facilitate better symmetry. Technically, it also provides more ef!cient work"ow accurate results. All efforts repairs have one ultimate...